Provider Demographics
NPI:1265066195
Name:LLORENTE, MEGAN NICOLE (IBCLC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:LLORENTE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MASLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25925 FAIRCOURT LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7517
Mailing Address - Country:US
Mailing Address - Phone:949-525-8769
Mailing Address - Fax:
Practice Address - Street 1:25925 FAIRCOURT LN
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7517
Practice Address - Country:US
Practice Address - Phone:949-525-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-29
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty