Provider Demographics
NPI:1598802928
Name:LAUER, SHAWNA MARIE HARTJE (MA, MFT)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MARIE HARTJE
Last Name:LAUER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1900
Mailing Address - Country:US
Mailing Address - Phone:510-207-0928
Mailing Address - Fax:
Practice Address - Street 1:3120 TELEGRAPH AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1900
Practice Address - Country:US
Practice Address - Phone:510-207-0928
Practice Address - Fax:510-269-9031
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2009-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist