Provider Demographics
NPI:1881765436
Name:CHIN, LAURA VALERIE (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:VALERIE
Last Name:CHIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19000 HOMESTEAD RD
Mailing Address - Street 2:CHILD AND ADOLESCENT PSYCHIATRY, BUILDING 2
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-0712
Mailing Address - Country:US
Mailing Address - Phone:408-366-4468
Mailing Address - Fax:408-366-4480
Practice Address - Street 1:19000 HOMESTEAD RD
Practice Address - Street 2:CHILD AND ADOLESCENT PSYCHIATRY, BUILDING 2
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-0712
Practice Address - Country:US
Practice Address - Phone:408-366-4468
Practice Address - Fax:408-366-4480
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS160531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical