Healthcare Provider Details

I. General information

NPI: 1720647126
Provider Name (Legal Business Name): LAUREN HARASYMIW MD, PHD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN JELENCHICK MPH

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

550 16TH ST
SAN FRANCISCO CA
94143-2549
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-8231
  • Fax:
Mailing address:
  • Phone: 415-502-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA177058
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA177058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: