Healthcare Provider Details

I. General information

NPI: 1255070082
Provider Name (Legal Business Name): LAUREN TAYLOR LAZO AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 SANTIAGO ST
SAN FRANCISCO CA
94116-1526
US

IV. Provider business mailing address

PO BOX 591033
SAN FRANCISCO CA
94159-1033
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number143564
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: