Provider Demographics
NPI:1992429963
Name:NGUYEN LAM, CATHERINE L
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:NGUYEN LAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:LANANH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4626 DANDELION LOOP
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-8772
Mailing Address - Country:US
Mailing Address - Phone:209-831-0313
Mailing Address - Fax:
Practice Address - Street 1:4626 DANDELION LOOP
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-8772
Practice Address - Country:US
Practice Address - Phone:209-831-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician