Provider Demographics
NPI:1326639386
Name:YORMACK, LAUREN ELIZABETH (CPD, NCS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:YORMACK
Suffix:
Gender:F
Credentials:CPD, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N HAYWORTH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3635
Mailing Address - Country:US
Mailing Address - Phone:303-919-4267
Mailing Address - Fax:
Practice Address - Street 1:123 N HAYWORTH AVE APT 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3635
Practice Address - Country:US
Practice Address - Phone:303-919-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAK61540OtherMEDICAL LIABILITY INSURANCE CARRIER CM&F