Fukasawa-Lara, Jennifer Kaori

Fukasawa-Lara, Jennifer Kaori is an sole proprietor health care provider with primary practice located at 600 N Highland Springs Ave , Banning CA 92220-3046. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Fukasawa-Lara, Jennifer Kaori can be contacted via phone (951) 845-1121.

Contact Information

Primary practice address
600 N Highland Springs Ave Banning CA 92220-3046
Phone: (951) 845-1121
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA54259 California

Profile Details

NPI number 1477093714
LBN Legal business name Fukasawa-Lara, Jennifer Kaori
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2017
Last updated Nov 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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