Healthcare Provider Details

I. General information

NPI: 1740360577
Provider Name (Legal Business Name): JAMES L LAZANSKY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 GRAY AVE # B
YUBA CITY CA
95991
US

IV. Provider business mailing address

1133 GRAY AVE # B
YUBA CITY CA
95991
US

V. Phone/Fax

Practice location:
  • Phone: 530-673-4129
  • Fax: 530-671-7563
Mailing address:
  • Phone: 530-673-4129
  • Fax: 530-671-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLC57127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: