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NPI Code Detail

MEDICARE: LOLO ENTENDENCIA RESP THERAPIST

MEDICARE: LOLO ENTENDENCIA RESP THERAPIST
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
1247200000XOther Technician00021562CA

General Provider Information

NPI Number : 1245369545
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOLO ENTENDENCIA RESP THERAPIST
Provider Business Mailing Address
First Line : 8978 BAINBRIDGE PL
Second Line :
City : STOCKTON
State : CA
Zip : 95209-4807
Country : US
Telephone Number : 209-470-6848
Fax Number : 209-474-1565
Provider Business Practice Location Address
First Line : 8978 BAINBRIDGE PL
Second Line :
City : STOCKTON
State : CA
Zip : 95209-4807
Country : US
Telephone Number : 209-470-6848
Fax Number : 209-474-1565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 07/08/2007

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Directions to “ LOLO ENTENDENCIA RESP THERAPIST” Practice Location

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