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Deactivated NPI 1477678977 Deactivated / Inactive NPI Female Practitioner

Lisa A. Granger , PA-C

Physician Assistant • Brea, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Lisa Granger has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 21, 2007
NPI Deactivation Date November 06, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Lisa Granger, PA-C was a registered Physician Assistant practicing in Brea, CA. Throughout an active medical career spanning 18 years, Lisa Granger provided care at the practice location at 539 S. BREA BLVD until profile deactivation on 2025-11-06.

Practice Location & Contact Primary Location

Practice Address

539 S. Brea Blvd

Brea, CA 92821

Telephone 7146712936
Fax 7146712938
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Brea, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.7 Yrs
State Avg: 11.5 Yrs
Regional Practice Density
14 Specialists

Practicing in Brea, CA (14617 Statewide)

Telehealth Adoption Rate
14.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License CA PA13418

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Mary Murdock , PA-C

Physician Assistant - Medical

NPI 1023026192

Physician Assistant (Certified)

Dawn Vollmann , PA

Family Medicine - Adult Medicine

NPI 1104335934

Physician Assistant

NPI 1205921756

Doctor of Medicine (M.D.)

NPI 1346495421

Doctor of Osteopathic Medicine (D.O.)

NPI 1972697605

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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NPI Profile Deactivated November 06, 2025

Record deactivated on November 06, 2025

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Updated Practice Location July 21, 2022

Registered at 23181 VERDUGO DR STE 103A, LAGUNA HILLS, CA 926531313 (Tel: 9493661053)

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Updated Business Mailing Address July 21, 2022

Registered at 23181 VERDUGO DR STE 103A, LAGUNA HILLS, CA 926531313 (Tel: 9493661053)

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Updated Practice Location July 05, 2022

Registered at 1007 SAN ANTONIO AVE., FULLERTON, CA 92835 (Tel: 7147455143)

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Provider Name / Credentials Updated July 05, 2022

Recorded as LISA OWEN, PA-C

NPI Profile Active January 31, 2011

NPI status registered as active in NPPES database

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Updated Practice Location January 31, 2011

Registered at 539 S. BREA BLVD, BREA, CA 92821 (Tel: 7146712936)

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Updated Business Mailing Address January 31, 2011

Registered at 1007 SAN ANTONIO AVE., FULLERTON, CA 92835 (Tel: 7147455143)

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Provider Name / Credentials Updated January 31, 2011

Recorded as LISA GRANGER, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2011

Physician Assistant (License #PA13418 in CA)

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Initial NPI Registration & Enumeration March 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477678977
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 21, 2007
Last Update: January 31, 2011
Deactivation Date: November 06, 2025

Mailing Address

1007 San Antonio Ave.

Fullerton, CA 92835

Phone: 7147455143

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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