Kennerly, Lara Danielle

Kennerly, Lara Danielle is an individual health care provider with primary practice located at 100 Prison Rd , Represa CA 95671-3000. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Kennerly, Lara Danielle can be contacted via phone (858) 229-3219.

Contact Information

Primary practice address
100 Prison Rd Represa CA 95671-3000
Phone: (858) 229-3219
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY29433 California

Profile Details

NPI number 1912074329
LBN Legal business name Kennerly, Lara Danielle
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Aug 23rd, 2022 - 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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