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: 07/07/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

550 16TH STREET 4TH FLOOR, BOX 0110
SAN FRANCISCO CA
94143
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 Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: