Healthcare Provider Details

I. General information

NPI: 1255222642
Provider Name (Legal Business Name): LAURA DEANNE REED AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58967 BUSINESS CENTER DR
YUCCA VALLEY CA
92284-7308
US

IV. Provider business mailing address

17800 US HIGHWAY 18
APPLE VALLEY CA
92307-1221
US

V. Phone/Fax

Practice location:
  • Phone: 760-369-3130
  • Fax:
Mailing address:
  • Phone: 760-552-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: