Healthcare Provider Details

I. General information

NPI: 1982580817
Provider Name (Legal Business Name): LAUREN NICOLE TOKUSHIGE PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 W ALWOOD ST
WEST COVINA CA
91790-3259
US

IV. Provider business mailing address

2021 W ALWOOD ST
WEST COVINA CA
91790-3259
US

V. Phone/Fax

Practice location:
  • Phone: 626-856-1693
  • Fax: 626-480-7125
Mailing address:
  • Phone: 626-856-1693
  • Fax: 626-480-7125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230155985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: