Provider Demographics
NPI:1942672779
Name:LOWE, LAUREN (MS, PSYD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:MS, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TAMAL VISTA BLVD STE 162
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1146
Mailing Address - Country:US
Mailing Address - Phone:415-323-6853
Mailing Address - Fax:
Practice Address - Street 1:21 TAMAL VISTA BLVD STE 162
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1146
Practice Address - Country:US
Practice Address - Phone:415-323-6853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31634103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist