Provider Demographics
NPI:1285793018
Name:PASCH, LAURI ALISON (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURI
Middle Name:ALISON
Last Name:PASCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2356 SUTTER ST FL 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3006
Mailing Address - Country:US
Mailing Address - Phone:415-353-3048
Mailing Address - Fax:415-353-7744
Practice Address - Street 1:2356 SUTTER ST FL 7
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3006
Practice Address - Country:US
Practice Address - Phone:415-353-3048
Practice Address - Fax:415-353-7744
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17671103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOPL17670Medicaid