Provider Demographics
NPI:1679875181
Name:OSTROW, LAURA MICHELLE (MFT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MICHELLE
Last Name:OSTROW
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14433 CATALINA ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5515
Mailing Address - Country:US
Mailing Address - Phone:510-351-3665
Mailing Address - Fax:510-351-3906
Practice Address - Street 1:14433 CATALINA ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5515
Practice Address - Country:US
Practice Address - Phone:510-351-3665
Practice Address - Fax:510-351-3906
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62921106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist