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General NPI Number Information
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NPI Number | 1962296129
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Entity Type | Individual
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Provider Name | LAURA BABCOCK MA, EDS
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Gender | Female
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 4700 LONE TREE WAY
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City | ANTIOCH
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State | CA
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Zip | 94531-8486
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Country | US
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Telephone | 925-779-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 510 G ST
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City | ANTIOCH
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State | CA
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Zip | 94509-1259
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Country | US
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Telephone | 925-779-7500
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Fax |
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 240187874
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License Number State | CA
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