Provider Demographics
NPI:1346030277
Name:JOHNSON, LAUREN CLARK
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CLARK
Last Name:JOHNSON
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 1:44349 LOWTREE AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4104
Mailing Address - Country:US
Mailing Address - Phone:661-228-0567
Mailing Address - Fax:205-509-5377
Practice Address - Street 1:44349 LOWTREE AVE STE 111
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4104
Practice Address - Country:US
Practice Address - Phone:661-228-0567
Practice Address - Fax:205-509-5377
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95035421163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse