Provider Demographics
NPI:1689902496
Name:DELMAR, LAURA G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:G
Last Name:DELMAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-4175
Mailing Address - Country:US
Mailing Address - Phone:951-371-4661
Mailing Address - Fax:
Practice Address - Street 1:8170 MONROE CT
Practice Address - Street 2:SUITE 150
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-307-1320
Practice Address - Fax:909-798-3607
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 13576101YM0800X
CALCS13576101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health