Healthcare Provider Details

I. General information

NPI: 1780096339
Provider Name (Legal Business Name): LAUREN ELIZABETH EATON M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E FOOTHILL BLVD SUITE 300
PASADENA CA
91107-3464
US

IV. Provider business mailing address

941 ROUNDTABLE CT
WALNUT CA
91789-4409
US

V. Phone/Fax

Practice location:
  • Phone: 626-993-3000
  • Fax:
Mailing address:
  • Phone: 909-518-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT110505
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: