Provider Demographics
NPI:1679084420
Name:NAMAN, LAURA NAGHAM (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:NAGHAM
Last Name:NAMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MORAGA RD STE D
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4567
Mailing Address - Country:US
Mailing Address - Phone:925-298-2737
Mailing Address - Fax:
Practice Address - Street 1:901 MORAGA RD STE D
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4567
Practice Address - Country:US
Practice Address - Phone:925-298-2737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29354103TC2200X
CA29354103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent