Healthcare Provider Details

I. General information

NPI: 1023817517
Provider Name (Legal Business Name): LORRAINE PAULE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SACRAMENTO ST
VALLEJO CA
94590-5901
US

IV. Provider business mailing address

303 SACRAMENTO ST
VALLEJO CA
94590-5901
US

V. Phone/Fax

Practice location:
  • Phone: 707-643-4545
  • Fax: 707-643-1349
Mailing address:
  • Phone: 707-643-4545
  • Fax: 707-643-1349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number756657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: