Provider Demographics
NPI:1366864464
Name:ROMANO, LORRAINE OLIVER (BCBA)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:OLIVER
Last Name:ROMANO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:MONET
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:6767 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-8984
Mailing Address - Country:US
Mailing Address - Phone:530-632-9415
Mailing Address - Fax:530-621-1397
Practice Address - Street 1:1990 MISTY MEADOW DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6289
Practice Address - Country:US
Practice Address - Phone:530-632-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11314385103K00000X
CA1-13-14385103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst