Healthcare Provider Details

I. General information

NPI: 1730130204
Provider Name (Legal Business Name): LORINDA M MAZZA R.N. P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 GARDEN CT
MONTEREY CA
93940-5302
US

IV. Provider business mailing address

19079 RED HAWK WAY
SALINAS CA
93908-1566
US

V. Phone/Fax

Practice location:
  • Phone: 831-646-8570
  • Fax: 831-646-5435
Mailing address:
  • Phone: 831-424-3300
  • Fax: 831-758-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN316641/PNP459
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNPF459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: