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NPI Code Detail

MEDICARE: MRS. LAURA MALANDRINO APCC

MEDICARE: MRS. LAURA MALANDRINO APCC
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
1101YM0800XMental Health CounselorCA

General Provider Information

NPI Number : 1790556512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA MALANDRINO APCC
Provider Business Mailing Address
First Line : 301 N PRAIRIE AVE STE 510
Second Line :
City : INGLEWOOD
State : CA
Zip : 90301-4512
Country : US
Telephone Number : 646-204-3546
Fax Number :
Provider Business Practice Location Address
First Line : 301 N PRAIRIE AVE STE 510
Second Line :
City : INGLEWOOD
State : CA
Zip : 90301-4512
Country : US
Telephone Number : 310-258-9677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2024
Last Update Date : 01/10/2024

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