Provider Demographics
NPI:1073546602
Name:LOSCO, JUDY A (DO)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:A
Last Name:LOSCO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:JESSAMINE
Other - Last Name:ALEJANDRINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-2026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 ROSE DR
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-2026
Practice Address - Country:US
Practice Address - Phone:714-528-4211
Practice Address - Fax:714-579-6868
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7090207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX70900Medicaid
CA20A7090Medicare ID - Type Unspecified
CAH09404Medicare UPIN