Provider Demographics
NPI:1417286923
Name:LIERAS, LAURA L
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:L
Last Name:LIERAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 N RIVIERA ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2306
Mailing Address - Country:US
Mailing Address - Phone:949-633-2243
Mailing Address - Fax:714-621-0315
Practice Address - Street 1:1260 N RIVIERA ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2306
Practice Address - Country:US
Practice Address - Phone:949-633-2243
Practice Address - Fax:714-621-0315
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator