Provider Demographics
NPI:1013642990
Name:SWANSICK, LAUREN CASEY
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:CASEY
Last Name:SWANSICK
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 1:1577 PERSHING DR APT A
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-3300
Mailing Address - Country:US
Mailing Address - Phone:209-207-2468
Mailing Address - Fax:
Practice Address - Street 1:2200 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1013
Practice Address - Country:US
Practice Address - Phone:415-750-5649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-23
Last Update Date:2022-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95193328163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent