MEDICARE: RICHARD LAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	104406	CA

General Provider Information

NPI Number	:	1093171605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD LAM

Provider Business Mailing Address
First Line	:	2660 SOLACE PL STE D2
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4337
Country	:	US
Telephone Number	:	650-567-6496
Fax Number	:

Provider Business Practice Location Address
First Line	:	2660 SOLACE PL STE D2
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4337
Country	:	US
Telephone Number	:	650-567-6496
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2016
Last Update Date	:	09/01/2020

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Directions to “ RICHARD LAM ” Practice Location

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