Provider Demographics
NPI:1073854758
Name:LAMOTTE, LANA GAYLENE (RN)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:GAYLENE
Last Name:LAMOTTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 HUNTINGTON DR
Mailing Address - Street 2:SUITE101
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4552
Mailing Address - Country:US
Mailing Address - Phone:626-403-4370
Mailing Address - Fax:626-403-4260
Practice Address - Street 1:1499 HUNTINGTON DR
Practice Address - Street 2:SUITE101
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4552
Practice Address - Country:US
Practice Address - Phone:626-403-4370
Practice Address - Fax:626-403-4260
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN494072163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health