Healthcare Provider Details

I. General information

NPI: 1588182000
Provider Name (Legal Business Name): LAURA ECHEVERRIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2017
Last Update Date: 09/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W ORANGE AVE
SOUTH SAN FRANCISCO CA
94080-4443
US

IV. Provider business mailing address

3265 26TH ST APT 18
SAN FRANCISCO CA
94110-4693
US

V. Phone/Fax

Practice location:
  • Phone: 745-817-7650
  • Fax:
Mailing address:
  • Phone: 415-583-6197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: