Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY12671 | CA |
NPI | 1285770172 |
---|---|
Provider Name | Dr. Ralph James Lamson |
First Address | San Rafael, CA 94903-3452 |
Second Address | San Rafael, CA 94903-3452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |