Provider Demographics
NPI:1811190077
Name:LOMBARDI, VICTORIA (RAS)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 E BARDSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-5400
Mailing Address - Country:US
Mailing Address - Phone:559-688-7531
Mailing Address - Fax:559-688-3509
Practice Address - Street 1:559 E BARDSLEY AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-5400
Practice Address - Country:US
Practice Address - Phone:559-688-7531
Practice Address - Fax:559-688-3509
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)