Provider Demographics
NPI:1164401154
Name:FARKAS, LORRAINE MARY (NP, RN,CNM)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:MARY
Last Name:FARKAS
Suffix:
Gender:F
Credentials:NP, RN,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 N WISHON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-6153
Mailing Address - Country:US
Mailing Address - Phone:559-443-1609
Mailing Address - Fax:559-224-3920
Practice Address - Street 1:35 CASA ST STE 220
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1890
Practice Address - Country:US
Practice Address - Phone:805-595-1808
Practice Address - Fax:805-595-1815
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA969363LW0102X
CA5639363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA295433OtherREGISTERED NURSE LIC
CA5639OtherNURSE PRACTITIONER LIC