Provider Demographics
NPI:1457525313
Name:ROMERO, LAURI (MA CJ)
Entity type:Individual
Prefix:MRS
First Name:LAURI
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MA CJ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 E 17TH ST
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8529
Mailing Address - Country:US
Mailing Address - Phone:714-657-6085
Mailing Address - Fax:
Practice Address - Street 1:1615 E 17TH ST
Practice Address - Street 2:SUITE #100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8529
Practice Address - Country:US
Practice Address - Phone:714-657-6085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator