Lake, Allen

Lake, Allen is an sole proprietor health care provider with primary practice located at 110 E D St Ste J , Benicia CA 94510-3252. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Lake, Allen can be contacted via phone (707) 413-7680.

Contact Information

Primary practice address
110 E D St Ste J Benicia CA 94510-3252
Phone: (707) 413-7680
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 93488 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 93488 California

Profile Details

NPI number 1972866721
LBN Legal business name Lake, Allen
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2012
Last updated Mar 17th, 2020 - about 5 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 1972866721 NPPES
California Other 484821 DRUG MEDI-CAL
California Other 84-4657784 DRUG MEDI-CAL

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