Provider Demographics
NPI:1104094820
Name:LAUX-TRAUTWEIN, JANINE SUSAN (MFT)
Entity type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:SUSAN
Last Name:LAUX-TRAUTWEIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 DUBLIN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2821
Mailing Address - Country:US
Mailing Address - Phone:510-610-2158
Mailing Address - Fax:925-456-6009
Practice Address - Street 1:11750 DUBLIN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2821
Practice Address - Country:US
Practice Address - Phone:510-610-2158
Practice Address - Fax:925-456-6009
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT40343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist