Provider Demographics
NPI:1407365521
Name:DEARING, LORETTA ANN
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:ANN
Last Name:DEARING
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 1:9718 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3635
Mailing Address - Country:US
Mailing Address - Phone:562-925-2777
Mailing Address - Fax:562-925-7572
Practice Address - Street 1:9718 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-3635
Practice Address - Country:US
Practice Address - Phone:562-925-2777
Practice Address - Fax:562-925-7572
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3428-R101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty