Healthcare Provider Details

I. General information

NPI: 1790693265
Provider Name (Legal Business Name): LORINA CORPUZ BENDO-DELERY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2885 SHANNON DR
SOUTH SAN FRANCISCO CA
94080-5321
US

IV. Provider business mailing address

2885 SHANNON DR
SOUTH SAN FRANCISCO CA
94080-5321
US

V. Phone/Fax

Practice location:
  • Phone: 650-799-3049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN177621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: