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1982904520
JUAN JOSE LARA
REDONDO BEACH, CA
NPI
1982904520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFC41135)
Enumeration Date
2010-10-29
Last Update Date
2010-10-29
Business Address
-- JUAN JOSE LARA MFT
901 N PACIFIC COAST HWY
REDONDO BEACH, CA 90277-2162
Phone number: 310-906-6752
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Mailing Address
-- JUAN JOSE LARA MFT
16039 NORDHOFF ST
NORTH HILLS, CA 91343-3041
Phone number: 818-720-8293
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