Provider Demographics
NPI:1629371489
Name:ISMAIL, LORI (LORI ISMAIL AAHCC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:ISMAIL
Suffix:
Gender:F
Credentials:LORI ISMAIL AAHCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3969 VIA CRISTOBAL
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2716
Mailing Address - Country:US
Mailing Address - Phone:408-871-0386
Mailing Address - Fax:
Practice Address - Street 1:3969 VIA CRISTOBAL
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2716
Practice Address - Country:US
Practice Address - Phone:408-871-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula