Provider Demographics
NPI:1669046843
Name:ALLORO-LICHTENSTEIN, PAULA JEAN (AGNP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:JEAN
Last Name:ALLORO-LICHTENSTEIN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-0002
Mailing Address - Country:US
Mailing Address - Phone:650-444-2132
Mailing Address - Fax:
Practice Address - Street 1:5820 STONERIDGE MALL RD STE 209
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3200
Practice Address - Country:US
Practice Address - Phone:510-573-4404
Practice Address - Fax:510-405-8989
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015313363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care