Provider Demographics
NPI:1578513818
Name:LAMBERT, JASON R (LCSW)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 W AVENUE J
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2866
Mailing Address - Country:US
Mailing Address - Phone:661-675-9638
Mailing Address - Fax:661-942-7115
Practice Address - Street 1:1669 W AVENUE J
Practice Address - Street 2:SUITE 202
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2866
Practice Address - Country:US
Practice Address - Phone:661-675-9638
Practice Address - Fax:661-942-7115
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 228291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 22829OtherCLINICAL SOCIAL WORKER