Provider Demographics
NPI:1801148754
Name:FRANKS, LAURA RAECHEL
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:RAECHEL
Last Name:FRANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:RAECHEL
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:731 E YOSEMITE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8039
Mailing Address - Country:US
Mailing Address - Phone:209-384-1779
Mailing Address - Fax:209-384-1076
Practice Address - Street 1:731 E YOSEMITE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8039
Practice Address - Country:US
Practice Address - Phone:209-384-1779
Practice Address - Fax:209-384-1076
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA173598156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician