Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | R1446271021 | CA |
NPI | 1003579970 |
---|---|
Provider Name | Tiffany Lamb |
First Address | San Diego, CA 92108-4108 |
Second Address | San Diego, CA 92102-2024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2021 |
Last Update Date | 18/10/2021 |