Provider Demographics
NPI:1740780816
Name:RHODES, LAURIAN
Entity Type:Individual
Prefix:
First Name:LAURIAN
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 58TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1526
Mailing Address - Country:US
Mailing Address - Phone:415-948-5845
Mailing Address - Fax:
Practice Address - Street 1:2118 WILLOW PASS RD STE 500
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2414
Practice Address - Country:US
Practice Address - Phone:925-692-0090
Practice Address - Fax:925-692-0090
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program