Provider Demographics
NPI:1659697027
Name:HAYDEN, LAUREN M (L AC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 5TH AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2364
Mailing Address - Country:US
Mailing Address - Phone:858-333-2151
Mailing Address - Fax:
Practice Address - Street 1:1940 5TH AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2364
Practice Address - Country:US
Practice Address - Phone:858-333-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13458171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist