Healthcare Provider Details

I. General information

NPI: 1043434046
Provider Name (Legal Business Name): VERONICA LARA B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 E ROMIE LN
SALINAS CA
93901-3123
US

IV. Provider business mailing address

30 E SAN JOAQUIN ST STE 102
SALINAS CA
93901-2946
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-7870
  • Fax: 831-755-7875
Mailing address:
  • Phone: 831-249-1308
  • Fax: 831-998-8704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number275801753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: