Healthcare Provider Details

I. General information

NPI: 1740498716
Provider Name (Legal Business Name): JENNIFER LAUSIER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N LINCOLN ST
DIXON CA
95620-2172
US

IV. Provider business mailing address

805 N LINCOLN ST
DIXON CA
95620-2172
US

V. Phone/Fax

Practice location:
  • Phone: 901-426-2853
  • Fax:
Mailing address:
  • Phone: 916-426-2853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number442
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: