Basic Information
| Provider Information | |||||||||
| NPI: | 1427093756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NELMS | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | D.P.M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1031 MIRAMONTE DR | ||||||||
| Address2: | APT 6 | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931091327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057334869 | ||||||||
| FaxNumber: | 8057331213 | ||||||||
| Practice Location | |||||||||
| Address1: | 2030 VIBORG RD STE 104 | ||||||||
| Address2: | |||||||||
| City: | SOLVANG | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934633224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056863961 | ||||||||
| FaxNumber: | 8057331213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 02/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0131X | E4325 | CA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
No ID Information.