Provider Demographics
NPI:1144550344
Name:KASPER, LAURA B (PHD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:KASPER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 MARKET ST STE 1108
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-5312
Mailing Address - Country:US
Mailing Address - Phone:415-734-1969
Mailing Address - Fax:
Practice Address - Street 1:582 MARKET ST STE 1108
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5312
Practice Address - Country:US
Practice Address - Phone:415-734-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000362103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist