Basic Information
| Provider Information | |||||||||
| NPI: | 1255916912 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUTFI | ||||||||
| FirstName: | ALLISON | ||||||||
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| Credential: | NP, CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5780 CALLE VISTA ALEGRE | ||||||||
| Address2: | |||||||||
| City: | YORBA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928872467 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 E VALENCIA MESA DR STE 310 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928353800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144465200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2021 | ||||||||
| LastUpdateDate: | 11/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364S00000X | 4881 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | 363L00000X | 95015050 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.