Provider Demographics
NPI:1881458230
Name:SHOUSE, ALAURA SHELEEN
Entity type:Individual
Prefix:MRS
First Name:ALAURA
Middle Name:SHELEEN
Last Name:SHOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:CA
Mailing Address - Zip Code:93271-0064
Mailing Address - Country:US
Mailing Address - Phone:559-561-4904
Mailing Address - Fax:
Practice Address - Street 1:16600 SHERMAN WAY STE 178
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3875
Practice Address - Country:US
Practice Address - Phone:818-235-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst