Healthcare Provider Details

I. General information

NPI: 1598678088
Provider Name (Legal Business Name): LAUREN JOSEPHINE CHILDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN JOSEPHINE THOMAS RDN

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 MOSS AVE
PASO ROBLES CA
93446-2720
US

IV. Provider business mailing address

532 MOSS AVE
PASO ROBLES CA
93446-2720
US

V. Phone/Fax

Practice location:
  • Phone: 949-375-2628
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: