Healthcare Provider Details

I. General information

NPI: 1194657387
Provider Name (Legal Business Name): LAUREN VANORSDALE AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S ORANGE GROVE BLVD
PASADENA CA
91105-1705
US

IV. Provider business mailing address

PO BOX 26234
LOS ANGELES CA
90026-0234
US

V. Phone/Fax

Practice location:
  • Phone: 310-431-9459
  • Fax:
Mailing address:
  • Phone: 424-272-0865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: