Provider Demographics
NPI:1760719645
Name:ADACHI, LAURIE KATHLEEN (MA, LEP ABSNP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:KATHLEEN
Last Name:ADACHI
Suffix:
Gender:F
Credentials:MA, LEP ABSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24359 WALNUT ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-6100
Mailing Address - Country:US
Mailing Address - Phone:661-255-2688
Mailing Address - Fax:661-255-0641
Practice Address - Street 1:24359 WALNUT ST
Practice Address - Street 2:UNIT A
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-6100
Practice Address - Country:US
Practice Address - Phone:661-255-2688
Practice Address - Fax:661-255-0641
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALEP1847103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool