Lamphere Sullivan, Georgina Ines
Lamphere Sullivan, Georgina Ines is an sole proprietor health care provider with primary practice located at 8253 White Oak Ave , Rancho Cucamonga CA 91730-7671. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lamphere Sullivan, Georgina Ines can be contacted via phone (909) 987-1997.Contact Information
Primary practice address
8253 White Oak Ave
Rancho Cucamonga CA 91730-7671
Phone: (909) 987-1997
Fax: (909) 978-0993
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY 10649 | California |
Profile Details
| NPI number | 1487633616 |
|---|---|
| LBN Legal business name | Lamphere Sullivan, Georgina Ines |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 16th, 2006 |
| Last updated | May 20th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487633616 | NPPES |
| California | Other | PSY 10649 | PH.D. LICENSE |
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