Provider Demographics
NPI:1023231552
Name:LORENZEN, SHAWN S (DC)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:S
Last Name:LORENZEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GOLF COURSE DR
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-1737
Mailing Address - Country:US
Mailing Address - Phone:707-585-8600
Mailing Address - Fax:
Practice Address - Street 1:101 GOLF COURSE DR
Practice Address - Street 2:SUITE C-2
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-1737
Practice Address - Country:US
Practice Address - Phone:707-585-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor