Provider Demographics
NPI:1427487909
Name:CROCI, LORI
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:CROCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6041
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95604-6041
Mailing Address - Country:US
Mailing Address - Phone:530-888-8664
Mailing Address - Fax:
Practice Address - Street 1:300 DAIRY RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3527
Practice Address - Country:US
Practice Address - Phone:530-888-8664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver