Provider Demographics
NPI:1598374563
Name:TONG, LAUREN REBECCA
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:REBECCA
Last Name:TONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 4TH ST UNIT 628
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-5525
Mailing Address - Country:US
Mailing Address - Phone:423-208-1591
Mailing Address - Fax:
Practice Address - Street 1:251 RHODE ISLAND ST STE 101
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-5168
Practice Address - Country:US
Practice Address - Phone:415-580-7604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035552235Z00000X
CA31723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist