Provider Demographics
NPI:1902193410
Name:SAKATA, LISSA CHRISTINA (M,D, MPH)
Entity Type:Individual
Prefix:DR
First Name:LISSA
Middle Name:CHRISTINA
Last Name:SAKATA
Suffix:
Gender:F
Credentials:M,D, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N BEAUREGARD ST STE 40
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1735
Mailing Address - Country:US
Mailing Address - Phone:703-359-8640
Mailing Address - Fax:703-591-6105
Practice Address - Street 1:1800 N BEAUREGARD ST STE 40
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1735
Practice Address - Country:US
Practice Address - Phone:703-359-8640
Practice Address - Fax:703-591-6105
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT202568208600000X
VA0101271194208600000X
PAMD4659232086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery