Healthcare Provider Details

I. General information

NPI: 1932546926
Provider Name (Legal Business Name): LAUREN MIZRAHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 NE 7TH AVE SUITE C-116
VANCOUVER WA
98685-4523
US

IV. Provider business mailing address

21600 OXNARD ST SUITE 1800
WOODLAND HILLS CA
91367-4976
US

V. Phone/Fax

Practice location:
  • Phone: 360-571-2432
  • Fax: 360-836-8131
Mailing address:
  • Phone: 818-345-2345
  • Fax: 818-449-0994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: