Provider Demographics
NPI:1609238286
Name:LORIA, ALISON
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:LORIA
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 1:242 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3408
Mailing Address - Country:US
Mailing Address - Phone:909-731-2909
Mailing Address - Fax:
Practice Address - Street 1:242 GARDEN ST
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-3408
Practice Address - Country:US
Practice Address - Phone:909-731-2909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA707631163W00000X
NY698268282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY698268OtherNEW YORK STATE LICENSE