Provider Demographics
NPI:1922120443
Name:HINES, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HINES
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 1:6431 MONTEREY RD
Mailing Address - Street 2:APT 1
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4369
Mailing Address - Country:US
Mailing Address - Phone:323-259-6459
Mailing Address - Fax:
Practice Address - Street 1:11502 S. VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-2630
Practice Address - Country:US
Practice Address - Phone:323-755-2742
Practice Address - Fax:310-876-0533
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner