Healthcare Provider Details

I. General information

NPI: 1245330158
Provider Name (Legal Business Name): LOIS INGBER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 VISTA WAY STE 258
OCEANSIDE CA
92056-4565
US

IV. Provider business mailing address

3633 CHESHIRE AVE
CARLSBAD CA
92010-7022
US

V. Phone/Fax

Practice location:
  • Phone: 760-758-1480
  • Fax: 760-435-9472
Mailing address:
  • Phone: 760-758-1480
  • Fax: 760-435-9472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS 11116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: