Provider Demographics
NPI:1932650223
Name:HO, LORENA (PSYD)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 LAUREL GROVE LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-4848
Mailing Address - Country:US
Mailing Address - Phone:661-487-2804
Mailing Address - Fax:
Practice Address - Street 1:199 LAUREL GROVE LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-4848
Practice Address - Country:US
Practice Address - Phone:661-487-2804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28376103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist