Basic Information
| Provider Information | |||||||||
| NPI: | 1477557429 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOCHRIDGE | ||||||||
| FirstName: | GLORIA | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 939 | ||||||||
| Address2: | |||||||||
| City: | ANGELS CAMP | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952220939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097546262 | ||||||||
| FaxNumber: | 8662068079 | ||||||||
| Practice Location | |||||||||
| Address1: | 18382 TUOLUMNE RD | ||||||||
| Address2: | |||||||||
| City: | TUOLUMNE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953799754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2099284004 | ||||||||
| FaxNumber: | 2099284988 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2005 | ||||||||
| LastUpdateDate: | 05/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 208513 | CA | N | Nursing Service Providers | Registered Nurse | 363L00000X | NP12021 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 364SC1501X | 57547 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Community Health/Public Health |
No ID Information.