Provider Demographics
NPI:1053472399
Name:LAMBERT, SUSAN HICKS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:HICKS
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23853 CAHUILLA CT
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-4194
Mailing Address - Country:US
Mailing Address - Phone:951-603-3042
Mailing Address - Fax:
Practice Address - Street 1:1975 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-5501
Practice Address - Country:US
Practice Address - Phone:562-218-4021
Practice Address - Fax:562-599-3934
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 193821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWSW19382AMedicare Oscar/Certification