NPI Code Details Logo

NPI 1942558721

NPI 1942558721 : LORENA A WATSON FNP : LAKEPORT, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1942558721
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    LORENA A WATSON FNP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/27/2012
-----------------------------------------------------
    Last Update Date     |    08/01/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    925 BEVINS COURT 
-----------------------------------------------------
    City                 |    LAKEPORT
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95453-9754
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    707-263-8383
-----------------------------------------------------
    Fax                  |    707-263-5019
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 1950 
-----------------------------------------------------
    City                 |    LAKEPORT
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95453-1950
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    707-262-8382
-----------------------------------------------------
    Fax                  |    707-263-1909
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    22120
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.