Provider Demographics
NPI:1538320817
Name:LA FLEUR, NADINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:
Last Name:LA FLEUR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3121
Mailing Address - Street 2:
Mailing Address - City:SHELL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-3121
Mailing Address - Country:US
Mailing Address - Phone:805-709-7793
Mailing Address - Fax:805-773-0946
Practice Address - Street 1:684 HIGUERA ST
Practice Address - Street 2:SUITE C
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3550
Practice Address - Country:US
Practice Address - Phone:805-709-7793
Practice Address - Fax:805-773-0946
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2011-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18245103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist