Provider Demographics
NPI:1811323314
Name:LERZA, LAUREN (PSYD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LERZA
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 1:13405 FOLSOM BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4738
Mailing Address - Country:US
Mailing Address - Phone:916-936-0084
Mailing Address - Fax:
Practice Address - Street 1:13405 FOLSOM BLVD STE 220
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4738
Practice Address - Country:US
Practice Address - Phone:916-936-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31651103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist