MEDICARE: LAUREN KAMPFF BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-15-19438	CA

General Provider Information

NPI Number	:	1720323058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN KAMPFF BCBA

Provider Business Mailing Address
First Line	:	PO BOX 33568
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-3568
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:	619-374-7134

Provider Business Practice Location Address
First Line	:	725 S MESA HILLS DR BLDG 3
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5568
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2012
Last Update Date	:	10/15/2024

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