Provider Demographics
NPI:1922402676
Name:HARTNETT, LAUREN K
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:K
Last Name:HARTNETT
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 1:325 ROLLING OAKS DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1088
Mailing Address - Country:US
Mailing Address - Phone:805-446-3141
Mailing Address - Fax:805-446-3140
Practice Address - Street 1:325 ROLLING OAKS DR
Practice Address - Street 2:SUITE 210
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1201
Practice Address - Country:US
Practice Address - Phone:805-446-3141
Practice Address - Fax:805-446-3140
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist