Provider Demographics
NPI:1417256801
Name:ALLEN, LAUNA K (PTN)
Entity Type:Individual
Prefix:
First Name:LAUNA
Middle Name:K
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PTN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 721275
Mailing Address - Street 2:
Mailing Address - City:PINON HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92372-1275
Mailing Address - Country:US
Mailing Address - Phone:760-868-6752
Mailing Address - Fax:
Practice Address - Street 1:1675 MORENA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3703
Practice Address - Country:US
Practice Address - Phone:619-275-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT35899167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician