Provider Demographics
NPI:1508093667
Name:PRESCOTT, LORI S (DC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:S
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CREEK RD
Mailing Address - Street 2:SUITE C-320
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4791
Mailing Address - Country:US
Mailing Address - Phone:949-784-4507
Mailing Address - Fax:949-872-2812
Practice Address - Street 1:33 CREEK RD
Practice Address - Street 2:SUITE C-320
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4791
Practice Address - Country:US
Practice Address - Phone:949-784-4507
Practice Address - Fax:949-872-2812
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor