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General NPI Number Information
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NPI Number | 1609767524
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Entity Type | Individual
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Provider Name | LORENA MICHELLE TREJO
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Gender | Female
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 5930 CORNERSTONE CT W
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City | SAN DIEGO
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State | CA
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Zip | 92121-3741
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Country | US
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Telephone | 866-687-7390
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Fax |
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Provider Business Mailing Address
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Address Line | 5712 N NEW HAMPSHIRE AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3135
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Country | US
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Telephone | 708-699-5257
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704412808
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1112349-30
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 967979
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95401275
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.522123
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License Number State | IL
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