Provider Demographics
NPI:1336790963
Name:WILLIAMS, LORILEA PAIGE (FNP)
Entity Type:Individual
Prefix:
First Name:LORILEA
Middle Name:PAIGE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37346 PASEO TULIPA
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-3702
Mailing Address - Country:US
Mailing Address - Phone:601-529-7054
Mailing Address - Fax:
Practice Address - Street 1:APEX MEDICAL GROUP
Practice Address - Street 2:890 WEST STETSON AVE # B
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543
Practice Address - Country:US
Practice Address - Phone:951-652-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine