Provider Demographics
NPI:1235327594
Name:PARTRIDGE, LAURA A (MFT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:A
Last Name:PARTRIDGE
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 1:2312 LAKE FOREST ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-4059
Mailing Address - Country:US
Mailing Address - Phone:760-738-6961
Mailing Address - Fax:
Practice Address - Street 1:327 S IVY ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4337
Practice Address - Country:US
Practice Address - Phone:760-470-4055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41526101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health