Provider Demographics
NPI:1396868600
Name:STERN, LISA (NP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:STERN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:STERN
Other - Last Name:SLIFKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2185 PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2309
Mailing Address - Country:US
Mailing Address - Phone:925-676-0505
Mailing Address - Fax:925-676-2814
Practice Address - Street 1:2185 PACHECO ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2309
Practice Address - Country:US
Practice Address - Phone:925-676-0505
Practice Address - Fax:925-676-2814
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003519363L00000X
CA747518363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner