Provider Demographics
NPI:1780365999
Name:MORAN, LAUREN NICHOL (CRNA)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NICHOL
Last Name:MORAN
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NICHOL
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAUREN SPENCE
Mailing Address - Street 1:1925 TOPEKA WAY
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-6311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1925 TOPEKA WAY
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-6311
Practice Address - Country:US
Practice Address - Phone:951-640-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95072799163W00000X
CA95002580367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse