Provider Demographics
NPI:1932430246
Name:LAMONT, MICHAEL ANTHONY (IMF)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:LAMONT
Suffix:
Gender:M
Credentials:IMF
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:LAMONT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IMF
Mailing Address - Street 1:6973 LINDA VISTA ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6342
Mailing Address - Country:US
Mailing Address - Phone:858-279-9676
Mailing Address - Fax:858-279-0377
Practice Address - Street 1:6973 LINDA VISTA ROAD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6342
Practice Address - Country:US
Practice Address - Phone:858-279-9676
Practice Address - Fax:818-279-0377
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF # 56004106H00000X
CAIMF 56004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist