Healthcare Provider Details

I. General information

NPI: 1134840598
Provider Name (Legal Business Name): LAUREN RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11731 TELEGRAPH RD STE K
SANTA FE SPRINGS CA
90670-6815
US

IV. Provider business mailing address

11731 TELEGRAPH RD STE K
SANTA FE SPRINGS CA
90670-6815
US

V. Phone/Fax

Practice location:
  • Phone: 562-949-8355
  • Fax:
Mailing address:
  • Phone: 562-949-8355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT163772
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT143655
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: