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Individual
JORDAN E LARA
Active
Individual
JORDAN E LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
CA
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
Primary
36749
CA
103TC0700X
Clinical Psychologist
Primary
PSY36749
CA
Other
Enumeration date
07/27/2023
Last updated
05/27/2026
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