Basic Information
| Provider Information | |||||||||
| NPI: | 1184868408 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAMB | ||||||||
| FirstName: | ELANA | ||||||||
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| Credential: | PEER ADVOCATE INTERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21045 VANOWEN ST APT 106 | ||||||||
| Address2: | |||||||||
| City: | CANOGA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913032865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8186680262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14660 OXNARD ST | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914113119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189014836 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2009 | ||||||||
| LastUpdateDate: | 04/30/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.