Healthcare Provider Details

I. General information

NPI: 1427969062
Provider Name (Legal Business Name): LAURA ELIZABETH BANKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S SAN PEDRO ST
LOS ANGELES CA
90013-2102
US

IV. Provider business mailing address

10244 ARROW RTE APT 116
RANCHO CUCAMONGA CA
91730-4789
US

V. Phone/Fax

Practice location:
  • Phone: 213-285-4260
  • Fax:
Mailing address:
  • Phone: 310-709-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: