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NPI Code Detail

MEDICARE: MS. LAUREN ELISE BRUINSMA LCSW136169

MEDICARE: MS. LAUREN ELISE BRUINSMA LCSW136169
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
1101YM0800XMental Health CounselorASW98521CA
21041C0700XClinical Social WorkerASW98521CA
31041C0700XClinical Social WorkerLCSW136169CA

General Provider Information

NPI Number : 1922549658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN ELISE BRUINSMA LCSW136169
Provider Business Mailing Address
First Line : 3200 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3740
Country : US
Telephone Number : 310-836-1223
Fax Number :
Provider Business Practice Location Address
First Line : 3200 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3710
Country : US
Telephone Number : 310-836-1223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2017
Last Update Date : 01/12/2026

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