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Individual
LARA ALLISON RAY
Active
Individual
LARA ALLISON RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY22240
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY22240
CA
103TB0200X
Cognitive & Behavioral Psychologist
PSY22240
CA
103TC0700X
Clinical Psychologist
Primary
PSY22240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497072888
CCS
CA
05
—
1497072888
—
CA
Enumeration date
04/26/2010
Last updated
11/30/2021
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