Individual
DR. LARA ADELINE WEYLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2220 MOUNTAIN BLVD, SUITE 240, OAKLAND, CA 94611-2905
(510) 531-5354
(510) 222-3508
Mailing address
5740 OLINDA RD, EL SOBRANTE, CA 94803-3542
(510) 222-9043
(510) 222-3508
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY14852
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY148520
—
CA
Enumeration date
09/21/2006
Last updated
07/08/2007
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