Provider Demographics
NPI:1720066723
Name:OSECHECK, LAURA HOLLEY (MS CCC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:HOLLEY
Last Name:OSECHECK
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:HOLLEY
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3970 ROCHDALE DR
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608
Mailing Address - Country:US
Mailing Address - Phone:916-487-7733
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:G101 UC DAVIS MEDICAL CENTER
Practice Address - City:SACREMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-3437
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10552235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
07187OtherUCDMC PI