Provider Demographics
NPI:1144304569
Name:NILLAS, NORINA LORA (NP)
Entity type:Individual
Prefix:
First Name:NORINA
Middle Name:LORA
Last Name:NILLAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3609 STARLING WAY
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92823-1050
Mailing Address - Country:US
Mailing Address - Phone:562-421-8799
Mailing Address - Fax:
Practice Address - Street 1:3130 S HARBOR BLVD
Practice Address - Street 2:250
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6824
Practice Address - Country:US
Practice Address - Phone:714-619-8777
Practice Address - Fax:714-619-8770
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA10460363LG0600X
NVAPN000825363LA2200X
NVRN46531163W00000X
CA543592163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN543592Medicaid
CARN543592Medicaid
NVMN1281841OtherDEA
CAS71037Medicare UPIN