Provider Demographics
NPI:1457784563
Name:GARCIA PISANI, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GARCIA PISANI
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 1:490 CHADBOURNE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-9613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21455 BIRCH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2165
Practice Address - Country:US
Practice Address - Phone:510-583-0414
Practice Address - Fax:510-583-0410
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist