Provider Demographics
NPI:1386146322
Name:BEJARANO, LORIANN (LMSW-ACSW)
Entity type:Individual
Prefix:
First Name:LORIANN
Middle Name:
Last Name:BEJARANO
Suffix:
Gender:F
Credentials:LMSW-ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E 1ST ST # 969
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3211
Mailing Address - Country:US
Mailing Address - Phone:619-788-8609
Mailing Address - Fax:
Practice Address - Street 1:360 E 1ST ST # 969
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3211
Practice Address - Country:US
Practice Address - Phone:619-788-8609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA909811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical