GUSTAVO N/A LARA

OAKLAND, CA
NPI1568168706
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101Y00000X Counselor
Enumeration Date2023-01-31
Last Update Date2023-02-03
Business Address
GUSTAVO N/A LARA
390 40TH ST
OAKLAND, CA 94609-2633
Phone number: 510-610-0330
Mailing Address
GUSTAVO N/A LARA
390 40TH ST.
OAKLAND, CA 94609
Phone number: 510-613-0330