Healthcare Provider Details

I. General information

NPI: 1417351909
Provider Name (Legal Business Name): LAURA TODD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 N CENTRAL AVE STE 2A
CAMPBELL CA
95008-1428
US

IV. Provider business mailing address

441 N CENTRAL AVE STE 2A
CAMPBELL CA
95008-1428
US

V. Phone/Fax

Practice location:
  • Phone: 669-256-0581
  • Fax:
Mailing address:
  • Phone: 669-256-0581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6235
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: