Provider Demographics
NPI:1124843461
Name:DE LA CRUZ, LOREN (HEALTH COACH)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:DE LA CRUZ
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4657 YORK RD UNIT 83
Mailing Address - Street 2:
Mailing Address - City:BUCKINGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:18912-6402
Mailing Address - Country:US
Mailing Address - Phone:201-658-7352
Mailing Address - Fax:
Practice Address - Street 1:4657 YORK RD UNIT 83
Practice Address - Street 2:
Practice Address - City:BUCKINGHAM
Practice Address - State:PA
Practice Address - Zip Code:18912-6402
Practice Address - Country:US
Practice Address - Phone:201-658-7352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach