Active NPI
Laurel Ann Waters, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Moraga, CA
National Provider Identifier
1841207677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- G46277
- Practice address
- 5 Dolores CT
Moraga, CA 94556-1574 - Phone
- (925) 457-3664
- Fax
- (925) 377-0543
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | G46277 | CA | Primary |
Addresses
Primary practice location
5 Dolores CT
Moraga, CA 94556-1574
Mailing address
5 Dolores CT
Moraga, CA 94556-1574
Phone (925) 457-3664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G46277 | CA | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1841207677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 DOLORES CT",
"city": "MORAGA",
"state": "CA",
"postal_code": "945561574",
"telephone_number": "925-457-3664",
"fax_number": "925-377-0543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 DOLORES CT",
"city": "MORAGA",
"state": "CA",
"postal_code": "945561574",
"telephone_number": "925-457-3664",
"fax_number": "925-377-0543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "LAUREL",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CA",
"license": "G46277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moraga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.