Provider Demographics
NPI:1972145290
Name:MABE, LAUREN NICOLE (MSN, RN, CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:MABE
Suffix:
Gender:F
Credentials:MSN, RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:3500 BARRANCA PKWY STE 160
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8228
Mailing Address - Country:US
Mailing Address - Phone:909-816-7016
Mailing Address - Fax:949-336-6570
Practice Address - Street 1:3500 BARRANCA PKWY STE 160
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8228
Practice Address - Country:US
Practice Address - Phone:949-336-6569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2326802208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics