Provider Demographics
NPI:1255640280
Name:HARRIS, LAURA STUVER (MSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:STUVER
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007
Mailing Address - Country:US
Mailing Address - Phone:760-943-8497
Mailing Address - Fax:
Practice Address - Street 1:1605 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:CARDIFF
Practice Address - State:CA
Practice Address - Zip Code:92007-2324
Practice Address - Country:US
Practice Address - Phone:760-943-8497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS182141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical