Provider Demographics
NPI:1992495899
Name:STANLEY, LAUREN A
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:STANLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15050 SHERMAN WAY UNIT 151
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2159
Mailing Address - Country:US
Mailing Address - Phone:661-618-2523
Mailing Address - Fax:
Practice Address - Street 1:15050 SHERMAN WAY UNIT 151
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2159
Practice Address - Country:US
Practice Address - Phone:661-618-2523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1065551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical