1447229232 NPI number — MRS. LAUREEN MARIE HEBERT CNM, FNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447229232 NPI number — MRS. LAUREEN MARIE HEBERT CNM, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEBERT
Provider First Name:
LAUREEN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNM, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEARY
Provider Other First Name:
LARUEEN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM, FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447229232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
KAISER PERMANENTE SAN MARCOS MEDICAL OFFICES OBGYN
Provider Second Line Business Mailing Address:
400 CRAVEN ROAD
Provider Business Mailing Address City Name:
SAN MARCOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-510-4046
Provider Business Mailing Address Fax Number:
760-510-4142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KAISER PERMANENTE SAN MARCOS MEDICAL OFFICES OBGYN
Provider Second Line Business Practice Location Address:
400 CRAVEN ROAD
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-510-4046
Provider Business Practice Location Address Fax Number:
760-510-4142
Provider Enumeration Date:
03/15/2006

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: 367A00000X , with the licence number:  NMW959 , 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)





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