Provider Demographics
NPI:1780096339
Name:EATON, LAUREN ELIZABETH (MS)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:EATON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 ROUNDTABLE CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4409
Mailing Address - Country:US
Mailing Address - Phone:909-518-4232
Mailing Address - Fax:
Practice Address - Street 1:2500 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3464
Practice Address - Country:US
Practice Address - Phone:626-993-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT110505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist