Provider Demographics
NPI:1457541443
Name:CHENG, LAURA Y
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:Y
Last Name:CHENG
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 1:2198 6TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2233
Mailing Address - Country:US
Mailing Address - Phone:510-207-9329
Mailing Address - Fax:
Practice Address - Street 1:2198 6TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2233
Practice Address - Country:US
Practice Address - Phone:510-207-9329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01CROtherMEDI-CAL