Basic Information
Provider Information
NPI: 1003001124
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAMPKIN
FirstName: MYLA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19915 RAY CIR
Address2:  
City: CERRITOS
State: CA
PostalCode: 907037547
CountryCode: US
TelephoneNumber: 3236337907
FaxNumber:  
Practice Location
Address1: 1605 EASTLAKE AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900331009
CountryCode: US
TelephoneNumber: 3232261871
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/11/2007
LastUpdateDate: 12/12/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLCSW28785CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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