Provider Demographics
NPI:1497964274
Name:LAMB, BARBARA PETERSON (MFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:PETERSON
Last Name:LAMB
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:MALLORY
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1517 MARJORIE AVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-3545
Mailing Address - Country:US
Mailing Address - Phone:909-626-8332
Mailing Address - Fax:909-625-4531
Practice Address - Street 1:1517 MARJORIE AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3545
Practice Address - Country:US
Practice Address - Phone:909-626-8332
Practice Address - Fax:909-625-4531
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT7855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT7855OtherMFT