Provider Demographics
NPI:1881751683
Name:ROMLEY, LOREN (LAC, DOM)
Entity type:Individual
Prefix:MS
First Name:LOREN
Middle Name:
Last Name:ROMLEY
Suffix:
Gender:F
Credentials:LAC, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4318
Mailing Address - Country:US
Mailing Address - Phone:831-227-6737
Mailing Address - Fax:
Practice Address - Street 1:550 WATER ST
Practice Address - Street 2:SUITE F1
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4124
Practice Address - Country:US
Practice Address - Phone:831-227-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10925171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist