Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCSW28785 | CA |
NPI | 1003001124 |
---|---|
Provider Name | Myla Lampkin |
First Address | Cerritos, CA 90703-7547 |
Second Address | Los Angeles, CA 90033-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 12/12/2017 |