Provider Demographics
NPI:1417530288
Name:LAM, JOCELYN (AMFT, APCC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 PARK BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1917
Mailing Address - Country:US
Mailing Address - Phone:408-914-8716
Mailing Address - Fax:
Practice Address - Street 1:2460 PARK BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1917
Practice Address - Country:US
Practice Address - Phone:408-914-8716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC4853101Y00000X
CAAMFT104920106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor