Provider Demographics
NPI:1295950384
Name:FRERKING, LAURA ANNE (MFT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANNE
Last Name:FRERKING
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 1:1874 CATALINA CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6416
Mailing Address - Country:US
Mailing Address - Phone:925-215-9508
Mailing Address - Fax:925-371-1989
Practice Address - Street 1:1874 CATALINA CT
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6416
Practice Address - Country:US
Practice Address - Phone:925-215-9508
Practice Address - Fax:925-371-1989
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist