Jacob Ingram Lara
Jacob Ingram Lara is a Rehabilitation Practitioner in Gilroy, California. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
9015 Murray Ave Ste 100Gilroy, CA 95020-3675
Phone: (408) 842-7138
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Specialties & licences
| Rehabilitation Practitioner (primary) | Taxonomy 225400000X |
|---|
Record details
| NPI number | 1801597505 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 10, 2023 |
| Last updated in NPPES | June 16, 2025 |
| Certification date | June 16, 2025 |
| Mailing address | 9015 Murray Ave Ste 100, Gilroy, CA 95020-3675 |
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Mrs. Melody Johnson-Boykins, CADCII
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