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General NPI Number Information
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NPI Number | 1235320789
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Entity Type | Individual
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Provider Name | LAURA MCGRADY PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 701 PALOMAR AIRPORT ROAD SUITE 300
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City | CARLSBAD
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State | CA
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Zip | 92011-1028
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Country | US
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Telephone | 760-688-0101
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Fax | 760-931-5617
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Provider Business Mailing Address
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Address Line | 701 PALOMAR AIRPORT ROAD SUITE 300
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City | CARLSBAD
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State | CA
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Zip | 92011-1028
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Country | US
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Telephone | 760-688-0101
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Fax | 760-931-5617
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY 21001
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License Number State | CA
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