Individual
CARMEN LUCILA LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2080 S E ST, SUITE 250, SAN BERNARDINO, CA 92408-2773
(909) 433-9300
(909) 433-9308
Mailing address
16207 GREENFIELD ST, MORENO VALLEY, CA 92551-7239
(909) 433-9300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/14/2007
Last updated
08/29/2012
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