Provider Demographics
NPI:1982249371
Name:LAUCHLAND, CARA E (CMT)
Entity Type:Individual
Prefix:MISS
First Name:CARA
Middle Name:E
Last Name:LAUCHLAND
Suffix:
Gender:F
Credentials:CMT
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 128
Mailing Address - Street 2:
Mailing Address - City:ACAMPO
Mailing Address - State:CA
Mailing Address - Zip Code:95220-0128
Mailing Address - Country:US
Mailing Address - Phone:209-276-5557
Mailing Address - Fax:
Practice Address - Street 1:800 W EIGHT MILE RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-9503
Practice Address - Country:US
Practice Address - Phone:209-276-5557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-09
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67636225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist