Healthcare Provider Details

I. General information

NPI: 1881889020
Provider Name (Legal Business Name): LORNA REED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 EMPIRE ST
FAIRFIELD CA
94533-5702
US

IV. Provider business mailing address

PO BOX 1824
NEWPORT OR
97365-0129
US

V. Phone/Fax

Practice location:
  • Phone: 707-425-5744
  • Fax:
Mailing address:
  • Phone: 707-425-5744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: