Provider Demographics
NPI:1447693429
Name:COATES, LAUREL (LM, CPM)
Entity type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:
Last Name:COATES
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2758 MATHEWS ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-2245
Mailing Address - Country:US
Mailing Address - Phone:510-816-6780
Mailing Address - Fax:
Practice Address - Street 1:2758 MATHEWS ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-2245
Practice Address - Country:US
Practice Address - Phone:510-816-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 366176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife