Provider Demographics
NPI:1639286792
Name:BIARDI, LAURA JUDITH (CNM)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JUDITH
Last Name:BIARDI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:JUDITH
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NMW
Mailing Address - Street 1:101 LAGUNA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3601
Mailing Address - Country:US
Mailing Address - Phone:714-992-5350
Mailing Address - Fax:
Practice Address - Street 1:101 LAGUNA RD STE 100
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3601
Practice Address - Country:US
Practice Address - Phone:714-992-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1547367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ32465Medicare UPIN