Healthcare Provider Details

I. General information

NPI: 1316232341
Provider Name (Legal Business Name): LAUREN SEVERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2067 W VISTA WAY STE 250
VISTA CA
92083-6034
US

IV. Provider business mailing address

2067 W VISTA WAY STE 250
VISTA CA
92083-6034
US

V. Phone/Fax

Practice location:
  • Phone: 562-490-9900
  • Fax: 562-452-7078
Mailing address:
  • Phone: 562-490-9900
  • Fax: 562-452-7078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC161498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: