Healthcare Provider Details

I. General information

NPI: 1043068356
Provider Name (Legal Business Name): LAUREN VICTORIA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN VICTORIA SNEDDON

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NOVELL PL
PROVO UT
84606-6171
US

IV. Provider business mailing address

305 E CENTER AVE
VISALIA CA
93291-6331
US

V. Phone/Fax

Practice location:
  • Phone: 801-200-6741
  • Fax:
Mailing address:
  • Phone: 877-960-3426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number67610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: