Provider Demographics
NPI:1275837460
Name:HYAMS, LAURA DRU (MFT;SCHOOL COUNSELOR)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DRU
Last Name:HYAMS
Suffix:
Gender:F
Credentials:MFT;SCHOOL COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-6145
Mailing Address - Country:US
Mailing Address - Phone:831-566-1076
Mailing Address - Fax:
Practice Address - Street 1:320 W CLIFF DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-6145
Practice Address - Country:US
Practice Address - Phone:831-566-1076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
CAMFC 48769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool