LORRAINE ANN PROVENZANO (NPI# 1063506160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063506160 |
| Entity Type | Individual |
| Full Name | LORRAINE ANN PROVENZANO |
| Credential | D.C. |
| Practice Address |
81709 Doctor Carreon Blvd Ste A5 Indio CA 92201-5509 |
| Practice Telephone | 7603422264 |
| Practice Fax Number | 7603424370 |
| Mailing Telephone | 7603422264 |
| Mailing Fax Number | 7603424370 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2008-03-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 16144 | CA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD PROVIDER # | DC0161440 | 01 |
| Street Address |
81709 DOCTOR CARREON BLVD STE A5 |
| City | INDIO |
| State | CA |
| Zip Code | 92201-5509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710071824 | Lorraine Provenzano, Chiropractic, Inc. | Chiropractor | 81709 Doctor Carreon Blvd Ste A5, Indio, CA 92201-5509 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151534 | Kayla Marie Berry | Licensed Vocational Nurse | Telecare Riverside County Psychiatric Health Facility, Indio, CA 92201 | 2020-03-31 |
| 1699327353 | Nawar Hadid | Dentist | 81735 Ca-111, Indio, CA 92201 | 2019-07-12 |
| 1427521889 | Thanh Trang Thi Nguyen Md Inc | Internal Medicine | 44100 Jefferson St., #e507, Indio, CA 92201 | 2019-01-09 |
| 1306328315 | Grant Nishimura | Dentist | 81-637, Suite 1, Ca-111, Indio, CA 92201 | 2018-09-06 |
| 1700363645 | Desert Physical Medicine | General Practice | 81765 Highway 111, Ste #3, Indio, CA 92201 | 2018-07-24 |
| 1336668151 | U & I Care Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 44105 Jackson St Ste 204, Indio, CA 92201 | 2017-09-13 |
| 1154847234 | Myung Kee Park | Dentist | 81106 Ca-111, #c, Indio, CA 92201 | 2017-08-21 |
| 1912434937 | Mirage Home Health | Home Health | 82691 Miles Ave, Indio, CA 92201 | 2017-05-22 |
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1497103758 | Timothy Smith | Contractor | 81337 Avenida Romero, Indio, CA 92201 | 2016-05-27 |
| Find all providers in zip 92201 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497294821 | Orthopedic and Physical Medicine Associates Inc | Chiropractor | 81765 Hwy 111, #3, Indio, CA 92201 | 2017-02-17 |
| 1760792279 | Ricardo Valdivia | Chiropractor | 80150 Us Highway 111 Ste C5, Indio, CA 92201-8360 | 2010-10-18 |
| 1427381342 | Stephen Richard Binder | Chiropractor | 81676 Avenida Sombra, Indio, CA 92203-7727 | 2009-09-10 |
| 1992837017 | Harry Warren | Chiropractor | 81833 Doctor Carreon Blvd Ste 4, Indio, CA 92201-5590 | 2007-03-12 |
| 1124161708 | Marco Antonio Cazares | Chiropractor | 81-480 Avenue 46. Suite 102, Indio, CA 92220 | 2007-02-14 |
| 1114099199 | Michael H Dawson | Chiropractor | 82013 Doctor Carreon Blvd, Suite B, Indio, CA 92201-5832 | 2006-11-14 |
| 1457468829 | Kurt A. Spurgin, Chiropractic Inc. | Chiropractor | 80545 Highway 111, Suite B, Indio, CA 92201 | 2006-08-23 |
| 1437266897 | Kurt Andrew Spurgin | Chiropractor | 80-545 Highway 111, Suite # B, Indio, CA 92201 | 2006-08-23 |
| 1396796785 | Eric Michael Davenport | Chiropractor | 80150 Us Highway 111, Suite C5, Indio, CA 92201-8359 | 2006-05-12 |
| 1356342026 | Stuart Alden Greenwood | Chiropractor | 81557 Dr Carreon Blvd, Suite B-5, Indio, CA 92201-5517 | 2005-08-03 |
| Find all providers in INDIO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.