Provider Demographics
NPI:1023316718
Name:FRANKLIN, LAURA B (LAC MS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:LAC MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1453
Mailing Address - Street 2:39108 CYPRESS WAY
Mailing Address - City:GUALALA
Mailing Address - State:CA
Mailing Address - Zip Code:95445-1453
Mailing Address - Country:US
Mailing Address - Phone:707-884-3203
Mailing Address - Fax:
Practice Address - Street 1:39108 CYPRESS WAY
Practice Address - Street 2:
Practice Address - City:GUALALA
Practice Address - State:CA
Practice Address - Zip Code:95445-8310
Practice Address - Country:US
Practice Address - Phone:707-884-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5375171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC5375OtherCALIFORNIA ACUPUNCTURE BOARD