Provider Demographics
NPI:1609880525
Name:LAURIE OSHAUGHNESSY PT SERVICES
Entity type:Organization
Organization Name:LAURIE OSHAUGHNESSY PT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHAUGHNESSY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:530-546-7581
Mailing Address - Street 1:PO BOX 1387
Mailing Address - Street 2:215 CARNELIAN BAY AVE SUITE A
Mailing Address - City:CARNELIAN BAY
Mailing Address - State:CA
Mailing Address - Zip Code:96140-1387
Mailing Address - Country:US
Mailing Address - Phone:530-546-7581
Mailing Address - Fax:530-546-7869
Practice Address - Street 1:215 CARNELIAN BAY ST
Practice Address - Street 2:SUITE A
Practice Address - City:CARNELIAN BAY
Practice Address - State:CA
Practice Address - Zip Code:96140
Practice Address - Country:US
Practice Address - Phone:530-546-7581
Practice Address - Fax:530-546-7869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT137040OtherMEDICARE
CA1679624613OtherBROOKE BARRETT NPI
CA1184774218OtherMICHELLE WILLIAMS NPI
CA1336298827OtherLAURIE OSHAUGHNESSY NPI