Provider Demographics
NPI:1063201028
Name:EICHMAN, LARA LADONNA
Entity type:Individual
Prefix:MRS
First Name:LARA
Middle Name:LADONNA
Last Name:EICHMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SPANISH ST
Mailing Address - Street 2:
Mailing Address - City:SUTTER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95685-9701
Mailing Address - Country:US
Mailing Address - Phone:209-257-7353
Mailing Address - Fax:
Practice Address - Street 1:330 SPANISH ST
Practice Address - Street 2:
Practice Address - City:SUTTER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95685-9701
Practice Address - Country:US
Practice Address - Phone:209-257-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool