Provider Demographics
NPI:1619705696
Name:LAMBERT, BRIAN MICHAEL
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:MICHAEL
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 GOLDENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6772
Mailing Address - Country:US
Mailing Address - Phone:415-310-1410
Mailing Address - Fax:
Practice Address - Street 1:210 N PASS AVE STE 202
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3936
Practice Address - Country:US
Practice Address - Phone:818-433-7831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health