Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY15697 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY15697 | CA |
NPI | 1003938549 |
---|---|
Provider Name | Ms. Zona C Lai |
First Address | La Jolla, CA 92037-3309 |
Second Address | La Jolla, CA 92037-3309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 14/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CP15697 | (02) | CA |