Provider Demographics
NPI:1518437623
Name:FOREMAN, LAUREN (CATC III)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:CATC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1942
Mailing Address - Country:US
Mailing Address - Phone:805-609-9388
Mailing Address - Fax:
Practice Address - Street 1:1911 WILLIAMS DR STE 160
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-609-9388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7089R101YA0400X
CA197088171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)