Provider Demographics
NPI:1891005930
Name:LAM, CECILIA W (BSC)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:W
Last Name:LAM
Suffix:
Gender:F
Credentials:BSC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:72 N BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2824
Mailing Address - Country:US
Mailing Address - Phone:408-998-2325
Mailing Address - Fax:408-998-2022
Practice Address - Street 1:2211 MOORPARK AVENUE
Practice Address - Street 2:SUITE 218
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2654
Practice Address - Country:US
Practice Address - Phone:408-998-2325
Practice Address - Fax:408-998-2022
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education