Provider Demographics
NPI:1629729256
Name:BUCHANAN, LAURA (SUDRC12761)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:SUDRC12761
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 GARDEN RD STE 201A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5338
Mailing Address - Country:US
Mailing Address - Phone:831-383-7800
Mailing Address - Fax:
Practice Address - Street 1:2560 GARDEN RD STE 201A
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5338
Practice Address - Country:US
Practice Address - Phone:831-383-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)