Provider Demographics
NPI:1427158518
Name:FOX-MEADOR, LAUREN CHRISTINE (MPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:FOX-MEADOR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:CHRISTINE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:46 LORI LN
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-1231
Mailing Address - Country:US
Mailing Address - Phone:805-484-9353
Mailing Address - Fax:805-497-9321
Practice Address - Street 1:1414 E THOUSAND OAKS BLVD
Practice Address - Street 2:211
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-4401
Practice Address - Country:US
Practice Address - Phone:805-497-0300
Practice Address - Fax:805-497-9321
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22425B225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT22425BOtherP.T. LICENSE
CAWPT22425BOtherP.T. LICENSE