Provider Demographics
NPI:1255663506
Name:EKLUND, LAURA MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MICHELLE
Last Name:EKLUND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:BURNS
Other - Last Name:FISCHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:739 MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6641
Mailing Address - Country:US
Mailing Address - Phone:925-266-3134
Mailing Address - Fax:
Practice Address - Street 1:739 MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6641
Practice Address - Country:US
Practice Address - Phone:925-266-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA696921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA12062699OtherCAQH
CALCSW-CA69692OtherBOARD OF BEHAVIORAL SCIENCE