Healthcare Provider Details

I. General information

NPI: 1598687550
Provider Name (Legal Business Name): LORIANN ELAINE DE MARTINI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 SOUSA COURT
PETALUMA CA
94952
US

IV. Provider business mailing address

705 SOUSA COURT
PETALUMA CA
94952
US

V. Phone/Fax

Practice location:
  • Phone: 707-776-7278
  • Fax:
Mailing address:
  • Phone: 707-776-7278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number39278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: