Provider Demographics
NPI:1699763672
Name:LORNE, ALLISON M (CNM)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:M
Last Name:LORNE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:CAYUCOS
Mailing Address - State:CA
Mailing Address - Zip Code:93430-1611
Mailing Address - Country:US
Mailing Address - Phone:303-475-5446
Mailing Address - Fax:
Practice Address - Street 1:1941 JOHNSON AVE STE 202
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4154
Practice Address - Country:US
Practice Address - Phone:805-548-0033
Practice Address - Fax:805-548-0034
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2013367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08224820Medicaid