Healthcare Provider Details

I. General information

NPI: 1427350545
Provider Name (Legal Business Name): LAURA CAROLA AVALOS SLUDER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA CAROLA AVALOS MA

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 HILYARD ST
EUGENE OR
97405-3866
US

IV. Provider business mailing address

1200 CODDINGTOWN CTR UNIT 6351
SANTA ROSA CA
95406-3513
US

V. Phone/Fax

Practice location:
  • Phone: 541-514-7997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC10215
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: