Individual ProviderLara Eleizabeth ColvertBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address1171 Homestead Rd Ste 250, Santa Clara, CA 95050-5485(408) 320-2590PECOS EnrollmentBased on the most recent information from CMS, provider Lara Eleizabeth Colvert does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1730645268Provider TypeIndividualFull NameColvert, Lara EleizabethGenderFemaleSole ProprietorNoEnumeration Date2/20/2019Last Updated2/20/2019Contact InformationPractice LocationPractice Address1171 Homestead Rd Ste 250, Santa Clara, CA 95050-5485Phone(408) 320-2590FaxUnlisted FaxMailing LocationMailing Address1171 Homestead Rd Ste 250, Santa Clara, CA 95050-5485Phone(408) 320-2590FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer