Provider Demographics
NPI:1134755762
Name:KRANCE, LAURA LYNN (DO)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:KRANCE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 PARK CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-6957
Mailing Address - Country:US
Mailing Address - Phone:619-596-5500
Mailing Address - Fax:619-596-5501
Practice Address - Street 1:655 PARK CENTER DR
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-6957
Practice Address - Country:US
Practice Address - Phone:619-596-5500
Practice Address - Fax:619-596-5501
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-15
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 390200000X, 314000000X
CA210322083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program