Provider Demographics
NPI:1740455468
Name:SOUZA, DENISE LORRIE (MSN, ANP-BC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LORRIE
Last Name:SOUZA
Suffix:
Gender:F
Credentials:MSN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1874 EMILY LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8644
Mailing Address - Country:US
Mailing Address - Phone:916-300-1536
Mailing Address - Fax:
Practice Address - Street 1:1874 EMILY LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8644
Practice Address - Country:US
Practice Address - Phone:916-300-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA378173163WC0400X, 363LA2200X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health