Provider Demographics
NPI:1548028111
Name:DESESA, LAURA (CLD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DESESA
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25655 PALMA ALTA DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2239
Mailing Address - Country:US
Mailing Address - Phone:323-251-9700
Mailing Address - Fax:
Practice Address - Street 1:25655 PALMA ALTA DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2239
Practice Address - Country:US
Practice Address - Phone:323-251-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula