Healthcare Provider Details

I. General information

NPI: 1114837317
Provider Name (Legal Business Name): LAURA ROSS MED, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 LOKER AVE E STE 110
CARLSBAD CA
92010-6683
US

IV. Provider business mailing address

PO BOX 17492
LONG BEACH CA
90807-7492
US

V. Phone/Fax

Practice location:
  • Phone: 888-341-4449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: