MEDICARE: LAUREN ELAN O'BRIEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	137438	CA

General Provider Information

NPI Number	:	1316894108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELAN O'BRIEN LCSW

Provider Business Mailing Address
First Line	:	PO BOX 46
Second Line	:
City	:	DAVENPORT
State	:	CA
Zip	:	95017-0046
Country	:	US
Telephone Number	:	831-508-0711
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 46
Second Line	:
City	:	DAVENPORT
State	:	CA
Zip	:	95017-0046
Country	:	US
Telephone Number	:	831-508-0711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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