Provider Demographics
NPI:1518037035
Name:ROMERO, LAURA ANN (IMFT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:ROMERO
Suffix:
Gender:F
Credentials:IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 E GILEA CT
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455
Mailing Address - Country:US
Mailing Address - Phone:805-739-8878
Mailing Address - Fax:
Practice Address - Street 1:105 N. LINCOLN AVE
Practice Address - Street 2:SANTA MARIA YOUTH AND FAMILY CENTER
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-928-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49172101YM0800X
LA2912101YP2500X
LA82164101YS0200X
LA867106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist