Provider Demographics
NPI:1841209079
Name:ROGEN, LAUREN BETH (RD)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:BETH
Last Name:ROGEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 GAYNOR AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1441
Mailing Address - Country:US
Mailing Address - Phone:818-789-4798
Mailing Address - Fax:
Practice Address - Street 1:5100 GAYNOR AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1441
Practice Address - Country:US
Practice Address - Phone:818-789-4798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA898967133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered