Provider Demographics
NPI:1942403043
Name:CHEUNG, LAURIE LAI (CDE)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:LAI
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:CDE
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:LAI SOU
Other - Last Name:CHEUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CDE
Mailing Address - Street 1:18288 SAGE CT
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4500
Mailing Address - Country:US
Mailing Address - Phone:408-741-5510
Mailing Address - Fax:
Practice Address - Street 1:750 S BASCOM AVE
Practice Address - Street 2:DIABETES ED
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2603
Practice Address - Country:US
Practice Address - Phone:408-885-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN308118163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator