Provider Demographics
NPI:1699062935
Name:MONES, LAUREN (OTR)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MONES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 STEINHART AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4045
Mailing Address - Country:US
Mailing Address - Phone:917-684-6968
Mailing Address - Fax:
Practice Address - Street 1:3916 SEPULVEDA BLVD
Practice Address - Street 2:208
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4640
Practice Address - Country:US
Practice Address - Phone:310-945-5705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT11960225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation