Provider Demographics
NPI:1518758093
Name:LARA, KARLA G
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:G
Last Name:LARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-4401
Mailing Address - Country:US
Mailing Address - Phone:805-742-3000
Mailing Address - Fax:
Practice Address - Street 1:515 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-4401
Practice Address - Country:US
Practice Address - Phone:805-742-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health