Healthcare Provider Details

I. General information

NPI: 1528923125
Provider Name (Legal Business Name): LAUREN PATRICE GARDINER CLEAR ADMINISTRATIVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 S STAGE COACH LN
FALLBROOK CA
92028-4426
US

IV. Provider business mailing address

2208 S STAGE COACH LN
FALLBROOK CA
92028-4426
US

V. Phone/Fax

Practice location:
  • Phone: 760-723-6395
  • Fax:
Mailing address:
  • Phone: 760-723-6395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: