Provider Demographics
NPI:1396887956
Name:LOLMAUGH, ADAM (MA)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:LOLMAUGH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-1853
Mailing Address - Country:US
Mailing Address - Phone:916-955-8431
Mailing Address - Fax:
Practice Address - Street 1:1150 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-5308
Practice Address - Country:US
Practice Address - Phone:916-609-4248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI #51743106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist