Provider Demographics
NPI:1144624743
Name:THOMAS, LAUREN SIERRA (PSYD)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:SIERRA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 E GLAUCUS ST
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1734
Mailing Address - Country:US
Mailing Address - Phone:805-455-0186
Mailing Address - Fax:
Practice Address - Street 1:380 E GLAUCUS ST
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1734
Practice Address - Country:US
Practice Address - Phone:805-455-0186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19361103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist