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General NPI Number Information
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NPI Number | 1073310470
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Entity Type | Individual
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Provider Name | LORRAINE NUNEZ-SANTANA BI
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 290 S PROSPECT AVE
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City | TUSTIN
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State | CA
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Zip | 92780-1522
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Country | US
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Telephone | 415-646-6223
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 E 59TH PL
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City | LOS ANGELES
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State | CA
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Zip | 90001-1212
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | Y9463133
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License Number State | CA
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