Provider Demographics
NPI:1730215633
Name:DAVIES, LAURA CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CATHERINE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WALNUT ST # 13052
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-3443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-422-9852
Practice Address - Street 1:1 BELVEDERE DR
Practice Address - Street 2:#200
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941
Practice Address - Country:US
Practice Address - Phone:415-335-6239
Practice Address - Fax:888-422-9852
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA664592084P0800X
CAA0664592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty