Provider Demographics
NPI:1023467297
Name:RICHARDS, LAUREN MARJORIE (MSCOT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARJORIE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MSCOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 E ESPLANADE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2179
Mailing Address - Country:US
Mailing Address - Phone:805-485-7000
Mailing Address - Fax:805-830-1777
Practice Address - Street 1:30856 AGOURA RD APT C3
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4349
Practice Address - Country:US
Practice Address - Phone:818-699-2771
Practice Address - Fax:805-830-1777
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16335225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist