Provider Demographics
NPI:1831510353
Name:HUNT, LAUREN SEASTROM (NP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:SEASTROM
Last Name:HUNT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9270
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-2470
Mailing Address - Country:US
Mailing Address - Phone:951-779-1670
Mailing Address - Fax:
Practice Address - Street 1:6926 BROCKTON AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3804
Practice Address - Country:US
Practice Address - Phone:951-779-1670
Practice Address - Fax:951-779-1679
Is Sole Proprietor?:No
Enumeration Date:2013-12-31
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000077363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty