Provider Demographics
NPI:1669666129
Name:LITTLE, LAMONT
Entity Type:Individual
Prefix:MS
First Name:LAMONT
Middle Name:
Last Name:LITTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 E VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-4607
Mailing Address - Country:US
Mailing Address - Phone:760-630-4573
Mailing Address - Fax:760-630-4973
Practice Address - Street 1:1010 E VISTA WAY
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-4607
Practice Address - Country:US
Practice Address - Phone:760-630-4573
Practice Address - Fax:760-630-4973
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)