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NPI Code Detail

MEDICARE: MADELINE LOVRENSKY PA

MEDICARE: MADELINE LOVRENSKY PA
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
1363A00000XPhysician Assistant
2363A00000XPhysician Assistant57530CA

General Provider Information

NPI Number : 1801448956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE LOVRENSKY PA
Provider Business Mailing Address
First Line : 5016 JEWEL ST UNIT 1616
Second Line :
City : ROCKLIN
State : CA
Zip : 95677-3266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 THARP RD
Second Line :
City : YUBA CITY
State : CA
Zip : 95993-9159
Country : US
Telephone Number : 530-844-5655
Fax Number : 530-671-8725
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2019
Last Update Date : 07/01/2024

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Directions to “ MADELINE LOVRENSKY PA” Practice Location

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