Provider Demographics
NPI:1891232674
Name:COMPTON, LAURA (APRN, MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:APRN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 MOORLAND ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2915
Mailing Address - Country:US
Mailing Address - Phone:412-877-6272
Mailing Address - Fax:
Practice Address - Street 1:549 MOORLAND ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2915
Practice Address - Country:US
Practice Address - Phone:412-877-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010279363LP0808X
CA95044853163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health