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NPI Code Detail

MEDICARE: LAURA HAGEN

MEDICARE:   LAURA  HAGEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1013337237
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA HAGEN
Provider Business Mailing Address
First Line : 716 OCEAN ST STE 170
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-4033
Country : US
Telephone Number : 831-423-2003
Fax Number :
Provider Business Practice Location Address
First Line : 716 OCEAN ST STE 170
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-4033
Country : US
Telephone Number : 831-423-2003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2014
Last Update Date : 05/12/2016

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Directions to “ LAURA HAGEN ” Practice Location

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