Lorena Cervantes

Key facts

NPI

1578069050

Entity type

Individual (NPI type 1)

Primary specialty

Student in an Organized Health Care Education/Training Program 390200000X

Practice address

1330 Lincoln Ave Ste 201
San Rafael, CA 94901-2142

Phone

(415) 459-5999

NPI assigned

Apr 3, 2018

Sex

Female

Sole proprietor

No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Institute for Psychotherapy Voluntary or Charitable Agency · San Rafael, CA · NPI 1760403794
  NPD (past)
• Community Institute for Psychotherapy Community/Behavioral Health Agency · San Rafael, CA · NPI 1780995258
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 3, 2018.

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1578069050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BIRCH WAY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032942",
            "telephone_number": "415-532-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE STE 201",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012142",
            "telephone_number": "415-459-5999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Birch Way",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949032942",
            "country_code": "US",
            "telephone_number": "415-532-6943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "LORENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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