Provider Demographics
NPI:1205044674
Name:LAMM, MARCIA GINGER (PHD QME)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:GINGER
Last Name:LAMM
Suffix:
Gender:F
Credentials:PHD QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21031 VENTURA BLVD
Mailing Address - Street 2:504
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2203
Mailing Address - Country:US
Mailing Address - Phone:818-340-1210
Mailing Address - Fax:818-340-1207
Practice Address - Street 1:21031 VENTURA BLVD
Practice Address - Street 2:504
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2203
Practice Address - Country:US
Practice Address - Phone:818-340-1210
Practice Address - Fax:818-340-1207
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9825103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP9825Medicare UPIN
CP9825Medicare ID - Type Unspecified