Provider Demographics
NPI:1861442741
Name:JAUREGUI-COVARRUBIAS, LORENA (MD)
Entity Type:Individual
Prefix:MS
First Name:LORENA
Middle Name:
Last Name:JAUREGUI-COVARRUBIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-3814
Mailing Address - Country:US
Mailing Address - Phone:928-550-1953
Mailing Address - Fax:
Practice Address - Street 1:2851 S AVENUE B BLDG 25
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7726
Practice Address - Country:US
Practice Address - Phone:928-336-7095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31336207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ774324001Medicaid
AZ774324001Medicaid