Provider Demographics
NPI:1881754638
Name:VERANO, LOURDES E (LAB SCIENTIST)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:E
Last Name:VERANO
Suffix:
Gender:F
Credentials:LAB SCIENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-7115
Mailing Address - Country:US
Mailing Address - Phone:707-469-0805
Mailing Address - Fax:
Practice Address - Street 1:2135 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-7115
Practice Address - Country:US
Practice Address - Phone:707-469-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTA34684246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist