Provider Demographics
NPI:1962782797
Name:VAN DER TOORN, LAUREL ROSE
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:ROSE
Last Name:VAN DER TOORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:ROSE
Other - Last Name:ROBERTS-MEESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2355 WESTWOOD BLVD #549
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064
Mailing Address - Country:US
Mailing Address - Phone:415-504-2895
Mailing Address - Fax:310-602-6455
Practice Address - Street 1:910 IRWIN ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3318
Practice Address - Country:US
Practice Address - Phone:415-457-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program