MEDICARE: LAUREN KOENIGSHOFER

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1699486779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN KOENIGSHOFER

Provider Business Mailing Address
First Line	:	1840 CAPITOL ST
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94590-5721
Country	:	US
Telephone Number	:	925-913-0723
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 CAPITOL ST
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	94590-5721
Country	:	US
Telephone Number	:	925-913-0723
Fax Number	:

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

Provider Enumeration Date	:	12/08/2022
Last Update Date	:	09/03/2025

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Directions to “ LAUREN KOENIGSHOFER ” Practice Location

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