Provider Demographics
NPI:1215492434
Name:SOUICE, LORRAINE K (CCAPP)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:K
Last Name:SOUICE
Suffix:
Gender:F
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEALTHCARE SERVICES INC.
Mailing Address - Street 2:3880 ROSECRANS ST.
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110
Mailing Address - Country:US
Mailing Address - Phone:619-515-0243
Mailing Address - Fax:
Practice Address - Street 1:971 MARLIN DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-5653
Practice Address - Country:US
Practice Address - Phone:760-936-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1629439286OtherSUD PROGRAM