Healthcare Provider Details

I. General information

NPI: 1528303146
Provider Name (Legal Business Name): ANGELICA LOUISANA LAMPA M.A., MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELICA LOUISANA SANCHEZ

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 TIENDA DRIVE STE 201
LODI CA
95242
US

IV. Provider business mailing address

1930 TIENDA DR STE 201
LODI CA
95242-3935
US

V. Phone/Fax

Practice location:
  • Phone: 209-867-7675
  • Fax: 209-333-9965
Mailing address:
  • Phone: 209-867-7675
  • Fax: 209-333-9965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW90033
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW136863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: