Provider Demographics
NPI:1063747624
Name:LAURENT, JULIE A (LCSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:LAURENT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3111
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-3111
Mailing Address - Country:US
Mailing Address - Phone:831-204-6392
Mailing Address - Fax:
Practice Address - Street 1:565 HARTNELL STREET
Practice Address - Street 2:3111
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-9394
Practice Address - Country:US
Practice Address - Phone:831-204-6392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605281041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA47-5249208Medicaid