Provider Demographics
NPI:1992522742
Name:ROSEN, LAUREN (LMFT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34145 PACIFIC COAST HWY # 210
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2731
Mailing Address - Country:US
Mailing Address - Phone:949-991-2600
Mailing Address - Fax:
Practice Address - Street 1:33635 BAYPORT WAY
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2134
Practice Address - Country:US
Practice Address - Phone:949-991-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110644106H00000X
UT12388215-3902106H00000X
NV4332-R106H00000X
ORT2249106H00000X
PAMF001632106H00000X
FLTPMF29106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist