Provider Demographics
NPI:1669016432
Name:LOTERY, FRAN
Entity Type:Individual
Prefix:DR
First Name:FRAN
Middle Name:
Last Name:LOTERY
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 1:310 WASHINGTON BLVD UNIT 304
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5168
Mailing Address - Country:US
Mailing Address - Phone:805-689-2283
Mailing Address - Fax:805-617-1735
Practice Address - Street 1:310 WASHINGTON BLVD UNIT 304
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5168
Practice Address - Country:US
Practice Address - Phone:805-689-2283
Practice Address - Fax:805-617-1735
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional