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NPI Code Detail

MEDICARE: LORRAINE LONNIE

MEDICARE:   LORRAINE  LONNIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1629117569
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRAINE LONNIE
Provider Business Mailing Address
First Line : 1 MOUNTAIN MEADOW RD
Second Line :
City : WOODSIDE
State : CA
Zip : 94062-4413
Country : US
Telephone Number : 650-796-9446
Fax Number :
Provider Business Practice Location Address
First Line : 251 JACKSON AVE
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94061-1630
Country : US
Telephone Number : 650-368-2383
Fax Number : 650-368-0599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 07/08/2007

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Directions to “ LORRAINE LONNIE ” Practice Location

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