Healthcare Provider Details

I. General information

NPI: 1952127292
Provider Name (Legal Business Name): LAUREN GRAWERT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 CHICHESTER CT
BAKERSFIELD CA
93314-4356
US

IV. Provider business mailing address

720 CHICHESTER CT
BAKERSFIELD CA
93314-4356
US

V. Phone/Fax

Practice location:
  • Phone: 925-665-9851
  • Fax: 661-427-2842
Mailing address:
  • Phone: 925-665-9851
  • Fax: 661-427-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALINE BALES
Title or Position: MANAGING MEMBER
Credential:
Phone: 925-665-9851