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NPI Code Detail

MEDICARE: LARA MICHELLE TAYLOR KESTER LMFT

MEDICARE: LARA MICHELLE TAYLOR KESTER 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
1106H00000XMarriage & Family Therapist112358CA

General Provider Information

NPI Number : 1790037927
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARA MICHELLE TAYLOR KESTER LMFT
Provider Business Mailing Address
First Line : 81 WOODVIEW RD
Second Line :
City : PITTSBURG
State : CA
Zip : 94565-2647
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 402 W BROADWAY STE 400
Second Line :
City : SAN DIEGO
State : CA
Zip : 92101-3554
Country : US
Telephone Number : 866-478-3978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2012
Last Update Date : 03/28/2023

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