Provider Demographics
NPI:1780421198
Name:BESERRA, LAUREN MARIE (CNM/WHNP-BC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:BESERRA
Suffix:
Gender:
Credentials:CNM/WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2563 N SKYTOP CT
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6492
Mailing Address - Country:US
Mailing Address - Phone:702-423-8707
Mailing Address - Fax:
Practice Address - Street 1:2563 N SKYTOP CT
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-6492
Practice Address - Country:US
Practice Address - Phone:702-423-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031082363LW0102X
CA236474176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health