Mader, Lothar Engelbert

Mader, Lothar Engelbert is an sole proprietor health care provider with primary practice located at 2130 Professional Dr Suite 240, Roseville CA 95661-3738. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Mader, Lothar Engelbert can be contacted via phone (916) 782-2100.

Contact Information

Primary practice address
2130 Professional Dr Suite 240 Roseville CA 95661-3738
Phone: (916) 782-2100
Fax: (916) 624-0701
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY8474 California

Profile Details

NPI number 1063400422
LBN Legal business name Mader, Lothar Engelbert
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2005
Last updated Nov 2nd, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063400422 NPPES
California MEDICAID 7366414

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