Individual
LORI MAE DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, MS, CCM
Contact information
Practice address
35 MILLER AVE STE 331, MILL VALLEY, CA 94941-1903
(415) 381-3133
Mailing address
35 MILLER AVE STE 331, MILL VALLEY, CA 94941-1903
(415) 381-3133
(415) 381-3131
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
381935
CA
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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