Healthcare Provider Details

I. General information

NPI: 1285034751
Provider Name (Legal Business Name): LAUREN HOUSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N EUCLID ST SUITE 300
ANAHEIM CA
92801-5510
US

IV. Provider business mailing address

2242 SHADETREE CIR
BREA CA
92821-4423
US

V. Phone/Fax

Practice location:
  • Phone: 714-871-5646
  • Fax: 714-817-7368
Mailing address:
  • Phone: 714-326-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: