Healthcare Provider Details

I. General information

NPI: 1326461351
Provider Name (Legal Business Name): LAUREN KRISTEN HARRISON AU.D., CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 CAMINO DEL RIO S STE 220
SAN DIEGO CA
92108-3817
US

IV. Provider business mailing address

39916 N GENERAL KEARNY RD
TEMECULA CA
92591-7322
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-6772
  • Fax:
Mailing address:
  • Phone: 951-234-9247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2946
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: