Individual provider Active NPI

Lorena A Watson, FNP

  • Family Nurse Practitioner
  • Lakeport, CA
National Provider Identifier
1942558721
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22120 Issued in CA
Practice address
925 Bevins Court
Lakeport, CA 95453-9754
Phone
(707) 263-8383
Fax
(707) 263-5019
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22120 CA Primary

Addresses

Primary practice location

925 Bevins Court
Lakeport, CA 95453-9754

Mailing address

PO Box 1950
Lakeport, CA 95453-1950
Phone (707) 262-8382

Other practice location 1

5108 Hill Road East
Lakeport, CA 95453
Phone (707) 262-1840

Other practice location 2

14440 Olympic Drive
Clearlake, CA 95422-8809
Phone (707) 263-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000623 CA Practitioner - Nurse Practitioner 0042460230 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Lake County Tribal Health Consortium IncGroup PAC ID 8729975545, 42 clinicians

Practice addresses (Care Compare)

925 Bevins CT
Lakeport, CA 95453-9754
Phone 70726383821204

Hospital & facility affiliations

  • Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Tribal Health Consortium Inc. CurrentSince Aug 26, 2024 Accepting new patients
Sutter Bay Hospitals CurrentSince Oct 27, 2014 Accepting new patients
Lake County Tribal Health Southshore Clinic CurrentSince Aug 26, 2024 Accepting new patients
Specialty Care and Surgery Center CurrentSince Aug 15, 2022 Accepting new patients
Specialty Care and Surgery Center CurrentSince Aug 15, 2022 Accepting new patients
Sutter Bay Hospitals Current Accepting new patients
Sutter Bay Hospitals CurrentSince Oct 27, 2014 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

14440 Olympic Dr
Clearlake, CA 95422
Phone (707) 263-8382

5685 Main St
Kelseyville, CA 95451
Phone (707) 279-8733

925 Bevins Ct
Lakeport, CA 95453
Phone (707) 263-8382

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

5196 Hill Rd E
Ste 300
Lakeport, CA 95453
Phone (707) 263-6885

Interoperability endpoints

  • Direct secure messaging: lwatson203825@hisp.ehr.sutterhealth.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lorena.watson.p1@direct.lcthc.nextgenshare.com

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1942558721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954531950",
            "telephone_number": "707-262-8382",
            "fax_number": "707-263-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BEVINS COURT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539754",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5108 Hill Road East",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "95453",
            "country_code": "US",
            "telephone_number": "707-262-1840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14440 Olympic Drive",
            "address_purpose": "LOCATION",
            "city": "Clearlake",
            "state": "CA",
            "postal_code": "954228809",
            "country_code": "US",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LORENA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.