Provider Demographics
NPI:1801660600
Name:LANIER PSYCHOLOGICAL SERVICES INC
Entity type:Organization
Organization Name:LANIER PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENICA
Authorized Official - Middle Name:FLORINA
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:760-889-5532
Mailing Address - Street 1:380 S MELROSE DR STE 357
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6641
Mailing Address - Country:US
Mailing Address - Phone:949-385-1339
Mailing Address - Fax:
Practice Address - Street 1:380 S MELROSE DR STE 357
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6641
Practice Address - Country:US
Practice Address - Phone:949-385-1339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty