Healthcare Provider Details

I. General information

NPI: 1659004596
Provider Name (Legal Business Name): JENNIFER BIANCA LORENZETTI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 W ORANGE AVE STE 105
ANAHEIM CA
92804-3152
US

IV. Provider business mailing address

3055 W ORANGE AVE STE 105
ANAHEIM CA
92804-3152
US

V. Phone/Fax

Practice location:
  • Phone: 714-638-8277
  • Fax:
Mailing address:
  • Phone: 714-638-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number800350
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number800350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: