Provider Demographics
NPI:1164975116
Name:FUECHSL, LAURA (BA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FUECHSL
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 PARKE ST
Mailing Address - Street 2:APT 15
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1072
Mailing Address - Country:US
Mailing Address - Phone:626-844-3033
Mailing Address - Fax:
Practice Address - Street 1:36 S KINNELOA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3853
Practice Address - Country:US
Practice Address - Phone:626-844-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator