Provider Demographics
NPI:1578701041
Name:KETTMANN, LAUREN ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:KETTMANN
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Gender:F
Credentials:PSYD
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Mailing Address - Street 1:1150 VETERANS BLVD
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2037
Mailing Address - Country:US
Mailing Address - Phone:650-299-4764
Mailing Address - Fax:650-299-4335
Practice Address - Street 1:1400 VETERANS BLVD
Practice Address - Street 2:DEPARTMENT OF PSYCHIARTY
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2612
Practice Address - Country:US
Practice Address - Phone:650-299-4764
Practice Address - Fax:650-299-4335
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2021-12-30
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Provider Licenses
StateLicense IDTaxonomies
CAPSY22182103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist