Provider Demographics
NPI:1780808592
Name:PAPPAS, LAURI (MASTERS)
Entity type:Individual
Prefix:MISS
First Name:LAURI
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1002
Mailing Address - Country:US
Mailing Address - Phone:510-495-4687
Mailing Address - Fax:
Practice Address - Street 1:1738 JEANNE CIR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6618
Practice Address - Country:US
Practice Address - Phone:925-372-7984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12484235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist