1366752370 NPI number — MS. CAROL HELAINE LAPERLE MFT

Table of content: MS. CAROL HELAINE LAPERLE MFT (NPI 1366752370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366752370 NPI number — MS. CAROL HELAINE LAPERLE MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAPERLE
Provider First Name:
CAROL
Provider Middle Name:
HELAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAPERLE
Provider Other First Name:
CAROL
Provider Other Middle Name:
HELAINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MFT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1366752370
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
423 F STREET
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
DAVIS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-341-3228
Provider Business Mailing Address Fax Number:
530-231-2819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
423 F STREET
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
DAVIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-341-3228
Provider Business Practice Location Address Fax Number:
530-231-2819
Provider Enumeration Date:
10/12/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 37551 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: MFC37551 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)