Provider Demographics
NPI:1124702568
Name:LANFRAY, ASTRID CAROLINA (BA)
Entity type:Individual
Prefix:
First Name:ASTRID
Middle Name:CAROLINA
Last Name:LANFRAY
Suffix:
Gender:
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 JENKINS ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2541
Mailing Address - Country:US
Mailing Address - Phone:714-317-6958
Mailing Address - Fax:
Practice Address - Street 1:118 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-2546
Practice Address - Country:US
Practice Address - Phone:714-986-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner