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NPI Code Detail

MEDICARE: LORISSA S TALAVERA

MEDICARE: LORISSA S TALAVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist94028280CA

General Provider Information

NPI Number : 1114870250
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORISSA S TALAVERA
Provider Business Mailing Address
First Line : 1650 E 4TH ST STE 101
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-5159
Country : US
Telephone Number : 877-611-2272
Fax Number :
Provider Business Practice Location Address
First Line : 1650 E 4TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-5151
Country : US
Telephone Number : 877-611-2272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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Directions to “ LORISSA S TALAVERA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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