Lorraine Ann Provenzano, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

16144 Issued in CA

Practice address

81709 Doctor Carreon Blvd Ste A5
Indio, CA 92201-5509

Phone

(760) 342-2264

Fax

(760) 342-4370

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205539200000",
    "number": "1063506160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81709 DOCTOR CARREON BLVD STE A5",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015509",
            "telephone_number": "760-342-2264",
            "fax_number": "760-342-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81709 DOCTOR CARREON BLVD STE A5",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015509",
            "telephone_number": "760-342-2264",
            "fax_number": "760-342-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENZANO",
        "first_name": "LORRAINE",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "16144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "DC0161440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kessler Warfield Prats
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• David Loren Proctor, RDAT
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• Ivona Prokolab
• Psychicure PC
• Franz Eddie Puentes
• Tatyana Pushkareva
• Mustaqeem Ahmed Qazi, MD
• Michael Quiceno, NP

• Chiropractor in Indio, CA
• Providers in Indio, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.