Basic Information
Provider Information
NPI: 1467989061
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LASKY
FirstName: ARIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 401 PARNASSUS AVE
Address2: BOX 0984
City: SAN FRANCISCO
State: CA
PostalCode: 94143
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 222 W 39TH AVE
Address2:  
City: SAN MATEO
State: CA
PostalCode: 94403
CountryCode: US
TelephoneNumber: 6505732222
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/15/2017
LastUpdateDate: 07/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XA157229CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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