Provider Demographics
NPI:1285758508
Name:GREGORY, LORNA (MSW)
Entity type:Individual
Prefix:MS
First Name:LORNA
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:LORNA
Other - Middle Name:GAIL
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PPSC
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-216-2172
Mailing Address - Fax:562-216-2337
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-216-2172
Practice Address - Fax:562-981-7569
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 137481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical