Provider Demographics
NPI:1578223574
Name:RIMASSA, LARA VASILJKA
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:VASILJKA
Last Name:RIMASSA
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 1:414 W TEAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6072
Mailing Address - Country:US
Mailing Address - Phone:559-691-3543
Mailing Address - Fax:767-737-2486
Practice Address - Street 1:414 W TEAGUE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-6072
Practice Address - Country:US
Practice Address - Phone:559-691-3543
Practice Address - Fax:765-737-2486
Is Sole Proprietor?:No
Enumeration Date:2021-12-19
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician