Provider Demographics
NPI:1033693254
Name:WARGIN, LAUREN ALISON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ALISON
Last Name:WARGIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ALISON
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CFY-SLP
Mailing Address - Street 1:6267 VIA TRATO
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-6085
Mailing Address - Country:US
Mailing Address - Phone:949-878-6624
Mailing Address - Fax:
Practice Address - Street 1:6267 VIA TRATO
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-6085
Practice Address - Country:US
Practice Address - Phone:949-878-6624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26059OtherSPEECH-LANGUAGE, HEARING LICENSING BOARD