LARA T. SAN PEDRO, PSY.D., A PSYCHOLOGICAL CORPORATION (NPI# 1225561103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225561103 |
| Entity Type | Organization |
| Organization Name | LARA T. SAN PEDRO, PSY.D., A PSYCHOLOGICAL CORPORATION |
| Practice Address |
39210 State St Suite 200 Fremont CA 94538-1456 |
| Practice Telephone | 2093730884 |
| Mailing Telephone | 2093730884 |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |
| Authorized Official Name | LARA SAN PEDRO (PSYCHOLOGIST) |
| Authorized Official Telephone | 2093730884 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 28229 | CA | Ambulatory Health Care Facilities |
| Street Address |
39210 STATE ST SUITE 200 |
| City | FREMONT |
| State | CA |
| Zip Code | 94538-1456 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649272832 | David C Gorsulowsky | Specialist | 39210 State St, Ste 218, Fremont, CA 94538-1456 | 2005-06-01 |
| 1730713298 | Diana Velasco | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2020-02-24 |
| 1033758180 | Johnathan Shay | Chiropractor | 39210 State St, Fremont, CA 94538-1456 | 2020-01-06 |
| 1306483466 | Madina Halim | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2019-12-06 |
| 1548819535 | Errol Vinoya Tongco Jr. | Physical Therapy Assistant | 39210 State St, Fremont, CA 94538-1456 | 2019-09-11 |
| 1457912826 | Nancy Ruiz | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2019-06-25 |
| 1932679545 | Shandrina M Jardine | Behavior Technician | 39210 State St, Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1790255263 | Jhoann Nicole Lopez Batac | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2018-11-27 |
| 1780169003 | Mallory Holt | Behavior Technician | 39210 State St, Fremont, CA 94538-1456 | 2018-10-02 |
| 1942785514 | Brandon Nelson Icban | Behavioral Analyst | 39210 State St, Fremont, CA 94538-1456 | 2018-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295349132 | Guiding Hands Rehab, Inc. | Clinic/Center | 606 W State St, Fremont, OH 43420-2534 | 2020-09-08 |
| 1518367846 | Golder Stone International, Inc | Clinic/Center | 46249 Warm Springs Blve Suite 1, Fremont, CA 94539 | 2014-08-22 |
| 1356611636 | Dr. Richard K. Skala Dc Qme Chiropractic Corporation | Clinic/Center | 5500 Stewart Ave, #113, Fremont, CA 94538-3100 | 2012-01-04 |
| 1962687566 | Columbia Asthma & Allergy Clinic | Clinic/Center | 3448 Mowry Ave, Fremont, CA 94538 | 2008-01-02 |
| 1053435248 | California Cardiovascular Consultant Medical Associates | Clinic/Center | 1900 Mowry Ave Ste 309, Fremont, CA 94538-1722 | 2007-03-16 |
| 1780292870 | American Current Care of California | Clinic/Center | 3161 Walnut Ave, Fremont, CA 94538-2216 | 2020-07-15 |
| 1750749891 | Hoda Spine & Msk Pain Company, Inc | Clinic/Center | 1860 Mowry Ave, Ste. 401, Fremont, CA 94538-1730 | 2016-02-03 |
| 1396053294 | Act Acupuncture Clinic Corp | Clinic/Center | 40788 Fremont Blvd, Fremont, CA 94538-4373 | 2010-09-14 |
| 1356664072 | Fremont Chiropractic Clinic PC | Clinic/Center | 415 E 23rd St, Suite 201, Fremont, NE 68025-2393 | 2010-03-09 |
| 1376797886 | Washington Township Hospital Development Corporation | Clinic/Center | 39141 Civic Center Dr, Suite 120, Fremont, CA 94538-5818 | 2008-11-11 |
| Find all providers in FREMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.