Healthcare Provider Details

I. General information

NPI: 1598731101
Provider Name (Legal Business Name): EVELYN WILMA LAMON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11665 AVENA PLACE SUITE 108
SAN DIEGO CA
92128
US

IV. Provider business mailing address

PO BOX 270927
SAN DIEGO CA
92198-0927
US

V. Phone/Fax

Practice location:
  • Phone: 858-668-6454
  • Fax: 858-679-7510
Mailing address:
  • Phone: 619-993-7508
  • Fax: 858-679-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS7890
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS7890
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: