Individual provider Active NPI

Denise A. Lorenz, N.P.

  • Nurse Practitioner
  • Lake Forest, CA
National Provider Identifier
1093724874
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
281288 Issued in CA
Practice address
23101 Lake Center Dr
Lake Forest, CA 92630-2801
Phone
(949) 716-9021
Fax
(949) 861-6810
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 281288 CA Primary

Addresses

Primary practice location

23101 Lake Center Dr
Lake Forest, CA 92630-2801

Mailing address

23101 Lake Center Dr
Lake Forest, CA 92630-2801
Phone (949) 716-9021

Other identifiers 2

IdentifierTypeStateIssuer
NP0164370OtherBLUE SHIELD OF CA
B077OtherCHAMPUS

Other names 1

  • Denise A. Marshall Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16437CAMDProfessional Counselor
281288CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1093724874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23101 LAKE CENTER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302801",
            "telephone_number": "949-716-9021",
            "fax_number": "949-861-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23101 LAKE CENTER DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302801",
            "telephone_number": "949-716-9021",
            "fax_number": "949-861-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZ",
        "first_name": "DENISE",
        "middle_name": "A.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "281288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "NP0164370",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "B077",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "MARSHALL",
            "middle_name": "A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.