Provider Demographics
NPI:1083738934
Name:LUMPKIN, LOIS M
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:M
Last Name:LUMPKIN
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 1:4015 AQUA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4317
Mailing Address - Country:US
Mailing Address - Phone:510-436-8361
Mailing Address - Fax:
Practice Address - Street 1:1000 WARD ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-1360
Practice Address - Country:US
Practice Address - Phone:925-335-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA309351163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse