Provider Demographics
NPI:1164316097
Name:CONTRERAS, LORENA
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:
Other - Last Name:GUERRERO MARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:PO BOX 10386
Mailing Address - Street 2:
Mailing Address - City:EARLIMART
Mailing Address - State:CA
Mailing Address - Zip Code:93219-0386
Mailing Address - Country:US
Mailing Address - Phone:661-458-1111
Mailing Address - Fax:
Practice Address - Street 1:311 S. STATE STREET
Practice Address - Street 2:
Practice Address - City:EARLIMART
Practice Address - State:CA
Practice Address - Zip Code:93219
Practice Address - Country:US
Practice Address - Phone:661-458-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96455225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist