| Doctor Name: | DR. CAREY E LAINE |
| NPI Number: | 1205834058 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PSY 21635 |
| Business Practice Address: | 590 Searls Ave # 12 Nevada City, CA - 959593043 |
| Business Phone Number: | 5302770976 |
| Business Fax Number: | 5302647136 |
| Mailing Address: | 590 Searls Ave # 12, NEVADA CITY |
| State: | CA |
| Postal Code: | 959593043 |
| Phone Number: | 5302770976 |
| Fax Number: | 5302647136 |
| NPI Enumeration Date: | 07/13/2005 |
| NPI Last Update Date: | 05/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | PSY 21635 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |