Provider Demographics
NPI:1669018354
Name:PHILLIPS, LAUREN BENZ (AMFT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BENZ
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:BENZ
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1664 MALTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-1022
Mailing Address - Country:US
Mailing Address - Phone:323-384-5334
Mailing Address - Fax:
Practice Address - Street 1:940 E UNION ST STE 102
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1780
Practice Address - Country:US
Practice Address - Phone:209-553-8157
Practice Address - Fax:818-698-6974
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist