Basic Information
| Provider Information | |||||||||
| NPI: | 1225695869 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABRAHAMSON | ||||||||
| FirstName: | LAUREN | ||||||||
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| Credential: | CNM, NP, MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 737 N CLARET LN | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOUSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953911285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5109094485 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 112 LA CASA VIA STE 300 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945983059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252390012 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2019 | ||||||||
| LastUpdateDate: | 05/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | 95011744 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 367A00000X | 236036 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 95011744 | 01 | CA | WHNP | OTHER | 236036 | 01 | CA | CNM | OTHER |