Individual provider · NPI-1

Lauren Frushon

Licensed Psychiatric Technician · Santa Maria, CA

NPI number1891151577
StatusActive
Last updated in NPPESJul 10, 2017

Details

NPI
1891151577
Entity type
Individual (NPI-1)
Name
Lauren Frushon
Sex
Female
Sole proprietor
No
Enumeration date
Jan 11, 2016
Last updated
Jul 10, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
167G00000X Licensed Psychiatric TechnicianPT34039CAYes
374700000X TechnicianPL034039CA

Practice location

2057 Mariah Dr
Santa Maria, CA 93454-5521

Phone 714-478-4505

Mailing address

2057 Mariah Dr
Santa Maria, CA 93454-5521

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