Healthcare Provider Details

I. General information

NPI: 1699361121
Provider Name (Legal Business Name): LORENNE HEALEY LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10751 DALE AVE
STANTON CA
90680-2604
US

IV. Provider business mailing address

10751 DALE AVE
STANTON CA
90680-2604
US

V. Phone/Fax

Practice location:
  • Phone: 714-215-3118
  • Fax:
Mailing address:
  • Phone: 714-821-5311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number211805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: