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

Lisa Suzanne Blackley, MD

Individual provider Emergency Medicine Physician · NPI 1821782053

Lisa Suzanne Blackley, MD is an Emergency Medicine in Moreno Valley, California. Qualified in 2023, 3 years ago. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone: (951) 486-5434
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence A200136 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1821782053
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 8, 2023
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026
Mailing address26520 Cactus Ave, Moreno Valley, CA 92555-3927

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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