Individual
THY AI LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 W VISTA WAY STE 407, VISTA, CA 92083-5714
(760) 758-1092
Mailing address
550 W VISTA WAY STE 407, VISTA, CA 92083-5714
(760) 758-1092
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95036841
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95016645
CA
Other
Enumeration date
04/15/2019
Last updated
03/05/2021
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