Provider Demographics
NPI:1588916084
Name:BROWN, LAURA DAWN (CADTP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DAWN
Last Name:BROWN
Suffix:
Gender:F
Credentials:CADTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 DOVER PKWY
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-3440
Mailing Address - Country:US
Mailing Address - Phone:661-725-2788
Mailing Address - Fax:
Practice Address - Street 1:355 DOVER PKWY
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-3440
Practice Address - Country:US
Practice Address - Phone:661-725-2788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10162101YA0400X
171M00000X
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator