Provider Demographics
NPI:1124670286
Name:JUAREZ, LORENA (MA)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 EASTBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1348
Mailing Address - Country:US
Mailing Address - Phone:916-243-9138
Mailing Address - Fax:916-243-9138
Practice Address - Street 1:285 W COURT ST STE 207
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2977
Practice Address - Country:US
Practice Address - Phone:916-243-9138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA158516101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health