Healthcare Provider Details

I. General information

NPI: 1568853547
Provider Name (Legal Business Name): LAUREN ALYCIA-LEE DILLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN ALYCIA LEE PHD

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 LURLINE DR
FOSTER CITY CA
94404-1832
US

IV. Provider business mailing address

941 LURLINE DR
FOSTER CITY CA
94404-1832
US

V. Phone/Fax

Practice location:
  • Phone: 415-494-9130
  • Fax:
Mailing address:
  • Phone: 415-494-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number26710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: