Provider Demographics
NPI:1346763067
Name:ALLERHAND, LAUREN AMY (PSYD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:AMY
Last Name:ALLERHAND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 242
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1271
Mailing Address - Country:US
Mailing Address - Phone:650-931-6519
Mailing Address - Fax:
Practice Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 242
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1271
Practice Address - Country:US
Practice Address - Phone:650-931-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31344103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31344OtherCALIFORNIA BOARD OF PSYCHOLOGY
NY024206OtherEDUCATION DEPARTMENT OF THE UNIVERSITY OF THE STATE OF NEW YORK