Provider Demographics
NPI:1841329570
Name:NESS, LAILA EVELYN (YOUTH CARE PROVIDER)
Entity type:Individual
Prefix:
First Name:LAILA
Middle Name:EVELYN
Last Name:NESS
Suffix:
Gender:F
Credentials:YOUTH CARE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 N.14TH STREET
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-1847
Mailing Address - Country:US
Mailing Address - Phone:805-481-5135
Mailing Address - Fax:
Practice Address - Street 1:541 N 14TH ST
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-1847
Practice Address - Country:US
Practice Address - Phone:805-481-5135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health