MEDICARE: SAMANTHA WEBER LAURIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	117785	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1932402732	OTHER		UNK
2	1932402737	OTHER	CA	NPI

General Provider Information

NPI Number	:	1932402732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA WEBER LAURIE

Provider Business Mailing Address
First Line	:	55 INDEPENDENCE CIR STE 106
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-4909
Country	:	US
Telephone Number	:	530-521-5818
Fax Number	:	530-521-5818

Provider Business Practice Location Address
First Line	:	55 INDEPENDENCE CIR STE 106
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95973-4909
Country	:	US
Telephone Number	:	530-521-5818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2010
Last Update Date	:	12/19/2022

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Directions to “ SAMANTHA WEBER LAURIE ” Practice Location

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