Individual
KRISTEN NIAN LASTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 MONTECITO AVE APT 5, MOUNTAIN VIEW, CA 94043-4549
(650) 386-6118
Mailing address
1300 MONTECITO AVE APT 5, MOUNTAIN VIEW, CA 94043-4549
(650) 386-6118
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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