Provider Demographics
NPI:1881720993
Name:ALKORAISHI, LARA WINDETT (MFT)
Entity type:Individual
Prefix:DR
First Name:LARA
Middle Name:WINDETT
Last Name:ALKORAISHI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:DR
Other - First Name:LARA
Other - Middle Name:
Other - Last Name:WINDETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, MFT
Mailing Address - Street 1:PO BOX 321201
Mailing Address - Street 2:
Mailing Address - City:LOST GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032
Mailing Address - Country:US
Mailing Address - Phone:408-892-3925
Mailing Address - Fax:
Practice Address - Street 1:2425 ENBORG LANE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2648
Practice Address - Country:US
Practice Address - Phone:408-885-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43984106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist