Lackovic, Andrea

Lackovic, Andrea is an individual health care provider with primary practice located at 4001 King Ave , Corcoran CA 93212-9611. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lackovic, Andrea can be contacted via phone (559) 992-8800.

Contact Information

Primary practice address
4001 King Ave Corcoran CA 93212-9611
Phone: (559) 992-8800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY23544 California

Profile Details

NPI number 1871612994
LBN Legal business name Lackovic, Andrea
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Mar 26th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871612994 NPPES
California Other PSY23544 CA LICENSE NUMBER

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