Provider Demographics
NPI:1396540985
Name:GUNN, LAURENCE
Entity type:Individual
Prefix:MRS
First Name:LAURENCE
Middle Name:
Last Name:GUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PENNYROYAL LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-7026
Mailing Address - Country:US
Mailing Address - Phone:415-761-0404
Mailing Address - Fax:
Practice Address - Street 1:2235 MERCURY WAY STE 107
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-5472
Practice Address - Country:US
Practice Address - Phone:415-761-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor