Healthcare Provider Details

I. General information

NPI: 1164401154
Provider Name (Legal Business Name): LORRAINE MARY FARKAS NP, RN,CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CASA ST STE 220
SAN LUIS OBISPO CA
93405-1890
US

IV. Provider business mailing address

1941 N WISHON AVE
FRESNO CA
93704-6153
US

V. Phone/Fax

Practice location:
  • Phone: 805-595-1808
  • Fax: 805-595-1815
Mailing address:
  • Phone: 559-443-1609
  • Fax: 559-224-3920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number969
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5639
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: