Provider Demographics
NPI:1750048583
Name:BENFANTI, LAUREN RENEE
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEE
Last Name:BENFANTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 300
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3628
Mailing Address - Country:US
Mailing Address - Phone:949-599-2434
Mailing Address - Fax:949-599-2430
Practice Address - Street 1:2071 SAN JOAQUIN HILLS RD
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6505
Practice Address - Country:US
Practice Address - Phone:949-759-1720
Practice Address - Fax:949-759-1442
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant