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1801597505
JACOB INGRAM LARA
GILROY, CA
NPI
1801597505
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2023-03-10
Last Update Date
2024-08-20
Business Address
JACOB INGRAM LARA
9015 MURRAY AVE STE 100
GILROY, CA 95020-3675
Phone number: 408-842-7138
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Mailing Address
JACOB INGRAM LARA
9015 MURRAY AVE STE 100
GILROY, CA 95020-3675
Phone number: 408-842-7138
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