Basic Information
| Provider Information | |||||||||
| NPI: | 1215115936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TURNER | ||||||||
| FirstName: | LAURA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1109 SIR FRANCIS DRAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | KENTFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949041418 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1109 SIR FRANCIS DRAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | KENTFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949041418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152569995 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2008 | ||||||||
| LastUpdateDate: | 02/14/2017 | ||||||||
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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 | 225700000X | CA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | 101Y00000X | CA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.