Healthcare Provider Details

I. General information

NPI: 1265066195
Provider Name (Legal Business Name): MEGAN NICOLE LLORENTE IBCLC, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN MASLER IBCLC

II. Dates (important events)

Enumeration Date: 02/29/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27800 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6410
US

IV. Provider business mailing address

27800 MEDICAL CENTER RD
MISSION VIEJO CA
92691-6410
US

V. Phone/Fax

Practice location:
  • Phone: 949-866-3600
  • Fax:
Mailing address:
  • Phone: 949-866-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: