Individual provider Active NPI

Lauren Elizabeth-Gray Coughran, O.T.

  • Pediatric Occupational Therapist
  • La Jolla, CA
National Provider Identifier
1447517370
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
12549 Issued in CA
Practice address
849 Coast Blvd
La Jolla, CA 92037
Phone
(800) 959-7010
NPI assigned
Apr 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 12549 CA Primary

Addresses

Primary practice location

849 Coast Blvd
La Jolla, CA 92037

Mailing address

3760 Convoy St.
Suite 204
San Diego, CA 92111-3742
Phone (858) 514-0375

Other names 1

  • Lauren Elizabeth Coughran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12549CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Speech Therapy Center Past Accepting new patients
PT in Motion Pediatrics PastSince Jun 11, 2014 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1447517370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST.",
            "address_2": "SUITE 204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113742",
            "telephone_number": "858-514-0375",
            "fax_number": "858-514-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 COAST BLVD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "800-959-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHRAN",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH-GRAY",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "12549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "COUGHRAN",
            "middle_name": "ELIZABETH",
            "credential": "O.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.