Provider Demographics
NPI:1497832042
Name:LAM, PAUL C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:LAM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:310 8TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-6526
Mailing Address - Country:US
Mailing Address - Phone:510-451-6729
Mailing Address - Fax:510-268-0202
Practice Address - Street 1:310 8TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6526
Practice Address - Country:US
Practice Address - Phone:510-451-6729
Practice Address - Fax:510-268-0202
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19446103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ20998Medicare UPIN
CAQPL194460Medicare PIN