Provider Demographics
NPI:1740695006
Name:MUSSER, LAUREN (MA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MUSSER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 CAMINO RUIZ
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-6700
Mailing Address - Country:US
Mailing Address - Phone:805-407-4241
Mailing Address - Fax:
Practice Address - Street 1:3655 ALAMO ST STE 300
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2187
Practice Address - Country:US
Practice Address - Phone:323-459-4968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78762106H00000X
CA108539106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist