Provider Demographics
NPI:1578038584
Name:LLOREN, CLARENCE LUMANSOC
Entity Type:Individual
Prefix:
First Name:CLARENCE
Middle Name:LUMANSOC
Last Name:LLOREN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21515 HAWTHORNE BLVD STE GL-100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6501
Mailing Address - Country:US
Mailing Address - Phone:424-571-2618
Mailing Address - Fax:
Practice Address - Street 1:21515 HAWTHORNE BLVD STE GL-100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6501
Practice Address - Country:US
Practice Address - Phone:424-571-2618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator