Provider Demographics
NPI:1326584186
Name:TARRANT, LAUREN ANN (SP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANN
Last Name:TARRANT
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:COYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-492-4870
Mailing Address - Fax:415-492-7871
Practice Address - Street 1:100 ROWLAND WAY STE 205
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5041
Practice Address - Country:US
Practice Address - Phone:415-492-4870
Practice Address - Fax:415-492-7871
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP29248OtherSTATE MEDICAL LICENSE