Healthcare Provider Details

I. General information

NPI: 1417599887
Provider Name (Legal Business Name): LAUREN SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 SAN JOSE ST
SALINAS CA
93901-3901
US

IV. Provider business mailing address

260 SAN JOSE ST
SALINAS CA
93901-3901
US

V. Phone/Fax

Practice location:
  • Phone: 318-757-8124
  • Fax: 831-757-3954
Mailing address:
  • Phone: 408-427-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number58472
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: