Provider Demographics
NPI:1679185649
Name:LORENTZEN, ANNE SF YU
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:SF YU
Last Name:LORENTZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12514 BUCKSKIN TRL
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-6012
Mailing Address - Country:US
Mailing Address - Phone:714-609-1798
Mailing Address - Fax:
Practice Address - Street 1:12514 BUCKSKIN TRL
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-6012
Practice Address - Country:US
Practice Address - Phone:714-609-1798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT37719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist