Individual
LAURA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 W RAMSEY ST, BANNING, CA 92220-4477
(951) 849-7142
(951) 849-1762
Mailing address
1330 W RAMSEY ST, BANNING, CA 92220-4477
(951) 849-7142
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
12/13/2024
Last updated
07/22/2025
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