Provider Demographics
NPI:1538880752
Name:WILLIAMS, LAURA LEI
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEI
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:LEI
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4835 FRAZEE RD APT 608
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6831
Mailing Address - Country:US
Mailing Address - Phone:619-908-0702
Mailing Address - Fax:
Practice Address - Street 1:2888 LOKER AVE E STE 309
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6686
Practice Address - Country:US
Practice Address - Phone:760-691-1513
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician