Healthcare Provider Details

I. General information

NPI: 1902378458
Provider Name (Legal Business Name): LORRAINE ABARO THOMAS PSYD, DRPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 02/22/2022
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 CALLE DE BARRANCA
REDLANDS CA
92373-6510
US

IV. Provider business mailing address

1508 BARTON RD # 186
REDLANDS CA
92373-1410
US

V. Phone/Fax

Practice location:
  • Phone: 909-255-2860
  • Fax: 909-796-0027
Mailing address:
  • Phone: 909-255-2860
  • Fax: 909-796-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY30267
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberPSY30267
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY30267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: