Healthcare Provider Details

I. General information

NPI: 1316038656
Provider Name (Legal Business Name): ANN MARIE KEEFER-LYNCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 S MAIN ST
ORANGE CA
92868-3833
US

IV. Provider business mailing address

3615 BANYON RIM RD
YORBA LINDA CA
92886-6916
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8000
  • Fax: 714-744-8630
Mailing address:
  • Phone: 714-693-8400
  • Fax: 714-744-8630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number357126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: