Healthcare Provider Details

I. General information

NPI: 1386020576
Provider Name (Legal Business Name): LORNE HARRIS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO ST STE 402
SAN FRANCISCO CA
94114-1040
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-4900
  • Fax: 415-369-1314
Mailing address:
  • Phone: 415-600-4900
  • Fax: 415-369-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95005551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: