Individual
MR. ALAN THOMAS LAMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1430 FREEDOM BLVD, WATSONVILLE, CA 95076-2780
(831) 763-8200
(831) 454-4663
Mailing address
1430 FREEDOM BLVD, WATSONVILLE, CA 95076-2780
(831) 763-8200
(831) 454-4663
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 13369
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCS13369
PROFESSIONAL LICENSE#
CA
01
—
ZZZ91891Z
MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
MEDICARE GROUP PTAN#
CA
Enumeration date
06/19/2007
Last updated
03/06/2014
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