Provider Demographics
NPI:1235698713
Name:ORR, LYNNE ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:ELIZABETH
Last Name:ORR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20126 STANTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5270
Mailing Address - Country:US
Mailing Address - Phone:510-537-3556
Mailing Address - Fax:
Practice Address - Street 1:20126 STANTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5270
Practice Address - Country:US
Practice Address - Phone:510-537-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018955363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner