Provider Demographics
NPI:1962633982
Name:LAGUNA, ALICIA (MFT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:LAGUNA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CRESCENT WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6781
Mailing Address - Country:US
Mailing Address - Phone:707-845-7101
Mailing Address - Fax:
Practice Address - Street 1:801 CRESCENT WAY STE 3
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6781
Practice Address - Country:US
Practice Address - Phone:707-845-7101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist