Provider Demographics
NPI:1033809967
Name:AUGUST, LOREN M
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:M
Last Name:AUGUST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 E BRIER DR STE 350
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-2875
Mailing Address - Country:US
Mailing Address - Phone:909-421-9233
Mailing Address - Fax:909-501-0833
Practice Address - Street 1:658 E BRIER DR STE 350
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2875
Practice Address - Country:US
Practice Address - Phone:909-421-9233
Practice Address - Fax:909-501-0833
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor