Individual
ANDREA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 INDIANA AVE, RIVERSIDE, CA 92506-4290
(909) 599-1227
Mailing address
4590 ALLSTATE DR, RIVERSIDE, CA 92501-1702
(909) 599-1227
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
119814
CA
Other
Enumeration date
04/19/2021
Last updated
11/29/2022
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