Provider Demographics
NPI:1235262635
Name:MINER, LAUREN ELIZABETH (CADC II)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:MINER
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-4543
Mailing Address - Country:US
Mailing Address - Phone:530-621-6256
Mailing Address - Fax:
Practice Address - Street 1:929 SPRING ST
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4543
Practice Address - Country:US
Practice Address - Phone:530-621-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03-996869174400000X
CAA054190419101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA03-996869OtherCAS II