Provider Demographics
NPI:1487849048
Name:ANJOLA, LAURA JEANNE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEANNE
Last Name:ANJOLA
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 1:923 DANA DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4020
Mailing Address - Country:US
Mailing Address - Phone:530-900-4000
Mailing Address - Fax:530-900-4444
Practice Address - Street 1:923 DANA DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4020
Practice Address - Country:US
Practice Address - Phone:530-900-4000
Practice Address - Fax:530-900-4444
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP17295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily