Provider Demographics
NPI:1265124226
Name:LAMAR, MELANIE S
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:S
Last Name:LAMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 N CHORRO ST APT 11
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1335
Mailing Address - Country:US
Mailing Address - Phone:510-559-0339
Mailing Address - Fax:
Practice Address - Street 1:1523 LONGBRANCH AVE
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2508
Practice Address - Country:US
Practice Address - Phone:805-473-7080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker