Healthcare Provider Details

I. General information

NPI: 1962769109
Provider Name (Legal Business Name): LORRAINE ASSUMMA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 12/04/2021
Certification Date: 12/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33205 TEMECULA PKWY
TEMECULA CA
92592-9142
US

IV. Provider business mailing address

33205 TEMECULA PKWY
TEMECULA CA
92592-9142
US

V. Phone/Fax

Practice location:
  • Phone: 951-303-3154
  • Fax:
Mailing address:
  • Phone: 951-303-3164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95007857
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number533607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: