Provider Demographics
NPI:1457043317
Name:LAM, JOANNE NGUYEN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:NGUYEN
Last Name:LAM
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10802 COLLEGE PL
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1505
Mailing Address - Country:US
Mailing Address - Phone:562-924-9581
Mailing Address - Fax:
Practice Address - Street 1:10802 COLLEGE PL
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1505
Practice Address - Country:US
Practice Address - Phone:562-924-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95025105363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health