Individual provider Active NPI

Christian Louis Lara

  • Licensed Psychiatric Technician
  • Laguna Hills, CA
National Provider Identifier
1215611942
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
41370 Issued in CA
Practice address
23161 Mill Creek Dr Ste 230
Laguna Hills, CA 92653-7935
Phone
(657) 261-7140
NPI assigned
Jun 13, 2023
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X 41370 CA Primary

Addresses

Primary practice location

23161 Mill Creek Dr Ste 230
Laguna Hills, CA 92653-7935

Mailing address

23161 Mill Creek Dr Ste 230
Laguna Hills, CA 92653-7935
Phone (657) 261-7140

Other practice location 1

12141 Brookhurst St Ste 201
Garden Grove, CA 92840-2865
Phone (657) 261-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation PastSince May 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1215611942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23161 MILL CREEK DR STE 230",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537935",
            "telephone_number": "657-261-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23161 MILL CREEK DR STE 230",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537935",
            "telephone_number": "657-261-7140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12141 Brookhurst St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928402865",
            "country_code": "US",
            "telephone_number": "657-261-7140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "CHRISTIAN",
        "middle_name": "LOUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "41370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.