Provider Demographics
NPI:1881288272
Name:LAM, WHITNEY (NP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19938 SHERMAN WAY APT D
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3655
Mailing Address - Country:US
Mailing Address - Phone:818-300-2752
Mailing Address - Fax:
Practice Address - Street 1:500 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1048
Practice Address - Country:US
Practice Address - Phone:818-300-2752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95066900163W00000X
CA2020037426363LA2100X
CA95015220363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care