Doctor Name: | LORRAINE SHERRILYN ANDERSON |
NPI Number: | 1073884490 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 81183 |
Business Practice Address: | 33361 Wallace Way Yucaipa, CA - 923993471 |
Business Phone Number: | 9099180003 |
Business Fax Number: | |
Mailing Address: | 33361 Wallace Way, YUCAIPA |
State: | CA |
Postal Code: | 923993471 |
Phone Number: | 9099180003 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2012 |
NPI Last Update Date: | 01/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 81183 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |