Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101Y00000X | Counselor | 94026430 | CA |
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103G00000X | Clinical Psychologist | 94026430 | CA |
N | 103TC0700X | Clinical Psychologist | 94026430 | CA |
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1285126201 |
---|---|
Provider Name | Ms. Lauraleigh Carol Hungerford |
First Address | San Rafael, CA 94903-1504 |
Second Address | San Rafael, CA 94903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 11/02/2022 |