Provider Demographics
NPI:1528234812
Name:LAMONT, SALLY MARIE BLAKE (ND)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:MARIE BLAKE
Last Name:LAMONT
Suffix:
Gender:F
Credentials:ND
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Mailing Address - Street 1:1100 LARKSPUR LANDING CIR #255
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939
Mailing Address - Country:US
Mailing Address - Phone:415-945-3213
Mailing Address - Fax:415-329-5080
Practice Address - Street 1:1100 LARKSPUR LANDING CIR #255
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939
Practice Address - Country:US
Practice Address - Phone:415-453-0708
Practice Address - Fax:415-456-1550
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 2843171100000X
CAND160175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist