MRS. LAURAINE MILDRED FOGARTY RADT-1 NPI 1134697980

NPI Information

NPI: 1134697980
Provider Name: MRS. LAURAINE MILDRED FOGARTY, RADT-1
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
580 GIANELLI ST
TRACY, CA
ZIP 95376
Phone: (510) 329-6153
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MRS. Lauraine Mildred Fogarty, RADT-1 is an addiction (substance use disorder) counselor in Tracy, CA. MRS. Lauraine Mildred Fogarty, RADT-1 NPI is 1134697980. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

580 GIANELLI ST
TRACY, CA
ZIP 95376-658
Phone: (510) 329-6153
Fax: (209) 834-8674

The enumeration date for this NPI number is 11/9/2018 and was last updated on 11/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	R1255740617	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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