Basic Information
| Provider Information | |||||||||
| NPI: | 1154971026 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAUZON | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | FRANCES SALVANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 547 PYRAMID CT | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945346650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072901473 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2000 EMBARCADERO STE 400 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946065300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105678101 | ||||||||
| FaxNumber: | 5105676850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2019 | ||||||||
| LastUpdateDate: | 09/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 38168 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.