Provider Demographics
NPI:1053056986
Name:WILLIAMS, LAUREN NICOLE (DO)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31951 DOVE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-3718
Mailing Address - Country:US
Mailing Address - Phone:949-557-0890
Mailing Address - Fax:949-557-0890
Practice Address - Street 1:LOMA LINDA UNIVERSITY HEALTH FAMILY MEDICINE
Practice Address - Street 2:11234 ANDERSON STREET
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA22010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program