Provider Demographics
NPI:1760604466
Name:LAURSEN, PAUL ASHLEY
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ASHLEY
Last Name:LAURSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4732
Mailing Address - Country:US
Mailing Address - Phone:916-993-4131
Mailing Address - Fax:916-993-4886
Practice Address - Street 1:650 HOWE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4732
Practice Address - Country:US
Practice Address - Phone:916-993-4131
Practice Address - Fax:916-993-4886
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker