Basic Information
| Provider Information | |||||||||
| NPI: | 1275757239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARREN | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | KATHERINE | ||||||||
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| Credential: | R.N., B.S.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2115 S. CENTERPOINTE PARKWAY | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053468427 | ||||||||
| FaxNumber: | 8053468279 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 S DORA ST | ||||||||
| Address2: | |||||||||
| City: | UKIAH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 954826340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074722720 | ||||||||
| FaxNumber: | 7074722735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 11/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 398195 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.