Provider Demographics
NPI:1295180727
Name:DRUSS, LAUREN (RD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DRUSS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 VINA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-3628
Mailing Address - Country:US
Mailing Address - Phone:818-497-4231
Mailing Address - Fax:
Practice Address - Street 1:2716 OCEAN PARK BLVD
Practice Address - Street 2:SUITE 3020
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5207
Practice Address - Country:US
Practice Address - Phone:310-829-9161
Practice Address - Fax:310-919-3567
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1064438133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered