Provider Demographics
NPI:1215255419
Name:MACE, TSUILEI LAM (EDD, LMFT)
Entity type:Individual
Prefix:
First Name:TSUILEI
Middle Name:LAM
Last Name:MACE
Suffix:
Gender:F
Credentials:EDD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 S LAKE AVE # 187
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3515
Mailing Address - Country:US
Mailing Address - Phone:626-538-9340
Mailing Address - Fax:
Practice Address - Street 1:2810 E DEL MAR BLVD STE 5
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4322
Practice Address - Country:US
Practice Address - Phone:626-538-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190258954101YS0200X
CA80116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool