Doctor Name: | LORI M MASON |
NPI Number: | 1023114865 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PMHNP |
License Number: | 095006984N6 |
Business Practice Address: | 5125 Skyway Paradise, CA - 959695624 |
Business Phone Number: | 5308762000 |
Business Fax Number: | 5308762586 |
Mailing Address: | 5125 Skyway, PARADISE |
State: | CA |
Postal Code: | 959695624 |
Phone Number: | 5308762000 |
Fax Number: | 5308762586 |
NPI Enumeration Date: | 09/16/2006 |
NPI Last Update Date: | 01/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 095006984N6 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |