Healthcare Provider Details

I. General information

NPI: 1437584521
Provider Name (Legal Business Name): LORRAINE MAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORRAINE CONVERSE

II. Dates (important events)

Enumeration Date: 09/07/2013
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 TULLY RD STE 301
SAN JOSE CA
95122-3055
US

IV. Provider business mailing address

1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US

V. Phone/Fax

Practice location:
  • Phone: 408-271-3900
  • Fax:
Mailing address:
  • Phone: 408-271-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: