Provider Demographics
NPI:1013354976
Name:MILLS, LAUREN N (PSYD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:N
Last Name:MILLS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12305 CHERRY GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3114
Mailing Address - Country:US
Mailing Address - Phone:805-402-9128
Mailing Address - Fax:
Practice Address - Street 1:12305 CHERRY GROVE ST
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-3114
Practice Address - Country:US
Practice Address - Phone:805-402-9128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29957103T00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health