Provider Demographics
NPI:1184868408
Name:LAMB, ELANA (PEER ADVOCATE INTERN)
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:PEER ADVOCATE INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21045 VANOWEN ST APT 106
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-2865
Mailing Address - Country:US
Mailing Address - Phone:818-668-0262
Mailing Address - Fax:
Practice Address - Street 1:14660 OXNARD ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-3119
Practice Address - Country:US
Practice Address - Phone:818-901-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst