Provider Demographics
NPI:1487889770
Name:RONDA, LAURA RHINE (BA, CSACII)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:RHINE
Last Name:RONDA
Suffix:
Gender:F
Credentials:BA, CSACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:58945 BUSINESS CENTER DR
Mailing Address - Street 2:STE. D
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7307
Mailing Address - Country:US
Mailing Address - Phone:760-228-9657
Mailing Address - Fax:760-368-6758
Practice Address - Street 1:58945 BUSINESS CENTER DR
Practice Address - Street 2:STE. D
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7307
Practice Address - Country:US
Practice Address - Phone:760-228-9657
Practice Address - Fax:760-368-6758
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CACORPHQ645022710A101YA0400X
CACORPHQ-645-022710A225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)