Provider Demographics
NPI:1760816425
Name:MATTHEWS, LAURA J (MSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FERN WAY
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3810
Mailing Address - Country:US
Mailing Address - Phone:847-951-5390
Mailing Address - Fax:
Practice Address - Street 1:6239 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1329
Practice Address - Country:US
Practice Address - Phone:510-473-2533
Practice Address - Fax:718-293-3980
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP89240104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker