Provider Demographics
NPI:1649435298
Name:KUREK, LAURA MAY JENKINS
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MAY JENKINS
Last Name:KUREK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 VALENCIA AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4165
Mailing Address - Country:US
Mailing Address - Phone:831-460-2550
Mailing Address - Fax:831-688-1718
Practice Address - Street 1:3060 VALENCIA AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4165
Practice Address - Country:US
Practice Address - Phone:831-460-2550
Practice Address - Fax:831-688-1718
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health