Healthcare Provider Details
I. General information
NPI: 1235513979
Provider Name (Legal Business Name): RANDI LYNN LAMPERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/13/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27201 TOURNEY RD 225
VALENCIA CA
91355-1854
US
IV. Provider business mailing address
27201 TOURNEY RD 225
VALENCIA CA
91355-1854
US
V. Phone/Fax
- Phone: 661-713-6746
- Fax:
- Phone: 661-713-6746
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 82571 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: