Provider Demographics
NPI:1912219213
Name:BOHN, LORILEE (DC)
Entity Type:Individual
Prefix:
First Name:LORILEE
Middle Name:
Last Name:BOHN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:BOHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, RN, PMHNP
Mailing Address - Street 1:25226 CABOT RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5504
Mailing Address - Country:US
Mailing Address - Phone:949-274-9972
Mailing Address - Fax:888-974-9872
Practice Address - Street 1:3151 AIRWAY AVE STE P3
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4626
Practice Address - Country:US
Practice Address - Phone:415-505-9311
Practice Address - Fax:888-974-9872
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29279111NN1001X
CA95036583163W00000X
CA95023907363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No111NN1001XChiropractic ProvidersChiropractorNutrition
No163W00000XNursing Service ProvidersRegistered Nurse