Provider Demographics
NPI:1790556512
Name:MALANDRINO, LAURA (APCC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:MALANDRINO
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N PRAIRIE AVE STE 510
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4512
Mailing Address - Country:US
Mailing Address - Phone:646-204-3546
Mailing Address - Fax:
Practice Address - Street 1:301 N PRAIRIE AVE STE 510
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4512
Practice Address - Country:US
Practice Address - Phone:310-258-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health