Healthcare Provider Details

I. General information

NPI: 1295513018
Provider Name (Legal Business Name): DAEJON LAMPTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 POWELL ST STE 900
EMERYVILLE CA
94608-1888
US

IV. Provider business mailing address

1045 CATALINA DR APT 5928
LIVERMORE CA
94550-5959
US

V. Phone/Fax

Practice location:
  • Phone: 510-982-3773
  • Fax:
Mailing address:
  • Phone: 209-683-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: