Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Marie Engelhardt, PA

Individual provider Physician Assistant · NPI 1790098473

Lisa Marie Engelhardt, PA is a Physician Assistant in Victorville, California. Qualified in 2009, 17 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
17
Licensed in
CA
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone: (760) 241-8000
Fax: (760) 962-8021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4300 Rose Dr, Yorba Linda, CA 92886-2026 — (714) 577-6680

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA20904 (CA)

Record details

NPI number1790098473
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 22, 2010
Last updated in NPPESMarch 16, 2022
Certification dateFebruary 17, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Victorville