Individual
MR. ALLEN LAKE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
110 E D ST STE J, BENICIA, CA 94510-3252
(707) 413-7680
Mailing address
110 E D ST STE J, BENICIA, CA 94510-3252
(707) 413-7680
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
93488
CA
1041C0700X
Clinical Social Worker
Primary
93488
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
484821
DRUG MEDI-CAL
CA
01
—
84-4657784
MENTAL HEALTH THERAPY
CA
Enumeration date
06/18/2012
Last updated
03/17/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us