Provider Demographics
NPI:1184806382
Name:AMITRANO, LORETTA J (FNP)
Entity type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:J
Last Name:AMITRANO
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:12900 PARK PLAZA DR
Mailing Address - Street 2:STE 150
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:562-977-4639
Mailing Address - Fax:526-741-4479
Practice Address - Street 1:544 W UMPQUA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471
Practice Address - Country:US
Practice Address - Phone:541-672-9596
Practice Address - Fax:541-464-3519
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2018-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ111603363LF0000X
OR200950086NP363LF0000X
NYF341031363LF0000X
AZAP2854363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR168395Medicaid
ORR103163OtherMEDICARE PART B
OR168395Medicaid