Healthcare Provider Details

I. General information

NPI: 1063159085
Provider Name (Legal Business Name): LAUREN ELIZABETH PLOTKIN LMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 S BASCOM AVE
CAMPBELL CA
95008-5526
US

IV. Provider business mailing address

2542 S BASCOM AVE STE 100
CAMPBELL CA
95008-5541
US

V. Phone/Fax

Practice location:
  • Phone: 408-475-1665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: