Provider Demographics
NPI:1629754759
Name:PICASSO, LIZETTE C (MSNE, MSED)
Entity type:Individual
Prefix:
First Name:LIZETTE
Middle Name:C
Last Name:PICASSO
Suffix:
Gender:F
Credentials:MSNE, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2067
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97015-2067
Mailing Address - Country:US
Mailing Address - Phone:415-846-5778
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2067
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97015-2067
Practice Address - Country:US
Practice Address - Phone:415-846-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No1744G0900XOther Service ProvidersSpecialistGraphics Designer