Provider Demographics
NPI:1700035789
Name:LAWSON, ANGELIINA LYNN (MA, ATR)
Entity Type:Individual
Prefix:MRS
First Name:ANGELIINA
Middle Name:LYNN
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MA, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1693 DEWAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3815
Mailing Address - Country:US
Mailing Address - Phone:805-815-9408
Mailing Address - Fax:
Practice Address - Street 1:4482 MARKET ST STE 406
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7780
Practice Address - Country:US
Practice Address - Phone:805-415-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health