JENNIFER KAORI FUKASAWA-LARA

BANNING, CA
NPI1477093714
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA54259)
Enumeration Date2017-03-06
Last Update Date2020-11-12
Business Address
JENNIFER KAORI FUKASAWA-LARA PA-C
600 N HIGHLAND SPRINGS AVE
BANNING, CA 92220-3046
Phone number: 951-845-1121
Mailing Address
JENNIFER KAORI FUKASAWA-LARA PA-C
38905 VISTA DR
CATHEDRAL CITY, CA 92234-2156
Phone number: 310-408-9476
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