Basic Information
Provider Information
NPI: 1003147950
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAPPEN
FirstName: AMY
MiddleName: ELIZABETH
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4249 BOYAR AVE
Address2:  
City: LONG BEACH
State: CA
PostalCode: 908073028
CountryCode: US
TelephoneNumber: (323) 377-5761
FaxNumber:  
Practice Location
Address1: 2301 E 28TH ST STE 309
Address2:  
City: SIGNAL HILL
State: CA
PostalCode: 907552181
CountryCode: US
TelephoneNumber: 3233775761
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/15/2010
LastUpdateDate: 09/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X22061CAY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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