Provider Demographics
NPI:1326592262
Name:GONZALEZ FIELDER, LAURA (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GONZALEZ FIELDER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:4179 PIEDMONT AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5186
Mailing Address - Country:US
Mailing Address - Phone:415-685-3894
Mailing Address - Fax:
Practice Address - Street 1:4179 PIEDMONT AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5186
Practice Address - Country:US
Practice Address - Phone:415-685-3894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90006106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist