Provider Demographics
NPI:1780159426
Name:TATARU, LORI MARIE (LAC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:MARIE
Last Name:TATARU
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 DOWNER ST STE A
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-4966
Mailing Address - Country:US
Mailing Address - Phone:530-712-9195
Mailing Address - Fax:530-712-9171
Practice Address - Street 1:1453 DOWNER ST STE A
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4966
Practice Address - Country:US
Practice Address - Phone:530-712-9195
Practice Address - Fax:530-712-9171
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist