Provider Demographics
NPI:1003175415
Name:MARASA, LAUREN HOFFMAN (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:HOFFMAN
Last Name:MARASA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 IRON POINT CIR STE 140
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8594
Mailing Address - Country:US
Mailing Address - Phone:916-209-0533
Mailing Address - Fax:916-209-4056
Practice Address - Street 1:50 IRON POINT CIR STE 140
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8594
Practice Address - Country:US
Practice Address - Phone:916-209-0533
Practice Address - Fax:916-209-4056
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KYR29762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program