Provider Demographics
NPI:1356010060
Name:CASAS, LAUREN LUE (BT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LUE
Last Name:CASAS
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 PEACOCK AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3768
Mailing Address - Country:US
Mailing Address - Phone:909-900-5848
Mailing Address - Fax:
Practice Address - Street 1:7511 PEACOCK AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3768
Practice Address - Country:US
Practice Address - Phone:909-900-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician