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Organization
PONCIANO WELLNESS, LLC
Active
Organization
PONCIANO WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANA LAMBDIN PH.D. (OPERATING MANAGER/ PROVIDER)
(888) 568-5640
Entity
Organization
Contact information
Practice address
5212 KATELLA AVE, SUITE 202, LOS ALAMITOS, CA 90720-2828
(888) 568-5640
(562) 493-0922
Mailing address
5212 KATELLA AVE, SUITE 202, LOS ALAMITOS, CA 90720-2828
(888) 568-5640
(562) 493-0922
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY15130
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326094442
NPPES
—
Enumeration date
05/12/2011
Last updated
05/12/2011
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