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801 Crescent Way Ste 4 Arcata CA 95521-6781 | |
| (707) 677-8200 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 801 Crescent Way Ste 4, Arcata, California |
| Authorized Official Name and Position | Jessica Lara (OWNER/PRESIDENT/CEO) |
| Authorized Official Contact | 7076778200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 Crescent Way Ste 4 Arcata CA 95521-6781 Ph: (707) 677-8200 | 801 Crescent Way Ste 4 Arcata CA 95521-6781 Ph: (707) 677-8200 |
| NPI Number | 1780319038 |
|---|---|
| Provider Enumeration Date | 07/20/2022 |
| Last Update Date | 01/24/2025 |
| Certification Date | 01/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780319038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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