MEDICARE: LARA SAYLES M.A., LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LMFT97213	CA

General Provider Information

NPI Number	:	1861737447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARA SAYLES M.A., LMFT

Provider Business Mailing Address
First Line	:	1910 HILLHURST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2712
Country	:	US
Telephone Number	:	818-600-1116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 HILLHURST AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2712
Country	:	US
Telephone Number	:	818-600-1116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	01/03/2023

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