Provider Demographics
NPI:1659537413
Name:VANEMAN, LAUREN (SPEECH SPECIALIST)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:VANEMAN
Suffix:
Gender:F
Credentials:SPEECH SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 WESTBOURNE DR APT 1
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-5124
Mailing Address - Country:US
Mailing Address - Phone:323-622-0731
Mailing Address - Fax:323-340-8298
Practice Address - Street 1:1111 W 6TH ST
Practice Address - Street 2:SUITE 111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1800
Practice Address - Country:US
Practice Address - Phone:323-622-0731
Practice Address - Fax:323-340-8298
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAV555525859280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV555525859280OtherSTATE OF CALIFORNIA