Healthcare Provider Details

I. General information

NPI: 1427515584
Provider Name (Legal Business Name): LAUREN TONECK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 CENTURY PARK E STE 400
LOS ANGELES CA
90067-2905
US

IV. Provider business mailing address

360 S EUCLID AVE UNIT 125
PASADENA CA
91101-3163
US

V. Phone/Fax

Practice location:
  • Phone: 800-465-3203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95008627
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number95008627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: