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General NPI Number Information
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NPI Number | 1841834264
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Entity Type | Individual
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Provider Name | JAMIE LANE
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Gender | Female
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 169 SAXONY RD STE 203
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City | ENCINITAS
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State | CA
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Zip | 92024-6780
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Country | US
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Telephone | 405-343-4101
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Fax |
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Provider Business Mailing Address
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Address Line | 153 S SIERRA AVE UNIT 292
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City | SOLANA BEACH
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State | CA
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Zip | 92075-8013
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Country | US
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Telephone | 405-343-4101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14678
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11063
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License Number State | OK
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