Provider Demographics
NPI:1063179745
Name:LAUREEN A LESTER
Entity type:Organization
Organization Name:LAUREEN A LESTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PYSD
Authorized Official - Phone:916-858-9346
Mailing Address - Street 1:7921 KINGSWOOD DR STE A3-I
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7710
Mailing Address - Country:US
Mailing Address - Phone:916-858-9346
Mailing Address - Fax:
Practice Address - Street 1:7921 KINGSWOOD DR STE A3-I
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7710
Practice Address - Country:US
Practice Address - Phone:916-858-9346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty