Provider Demographics
NPI:1255180667
Name:PARRELLA, LOREN
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:PARRELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6766 BROOKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-2932
Mailing Address - Country:US
Mailing Address - Phone:530-219-1278
Mailing Address - Fax:
Practice Address - Street 1:6766 BROOKLYN AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-2932
Practice Address - Country:US
Practice Address - Phone:530-219-1278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach