Provider Demographics
NPI:1861067423
Name:STRULL, LAUREN ERICA (SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ERICA
Last Name:STRULL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4941 EDGERTON AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1201
Mailing Address - Country:US
Mailing Address - Phone:818-468-7049
Mailing Address - Fax:
Practice Address - Street 1:4941 EDGERTON AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1201
Practice Address - Country:US
Practice Address - Phone:818-468-7049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21038235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist