Healthcare Provider Details

I. General information

NPI: 1568300614
Provider Name (Legal Business Name): LAUREN MICHELLE MOROVATI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3223 W 6TH ST
LOS ANGELES CA
90020-5005
US

IV. Provider business mailing address

779 S SANTA ANITA AVE
SAN MARINO CA
91108-1540
US

V. Phone/Fax

Practice location:
  • Phone: 626-677-8670
  • Fax:
Mailing address:
  • Phone: 626-677-8670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95040322
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95219675
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: