Lake, Susan

Lake, Susan is an individual health care provider with primary practice located at 1330 Lincoln Ave Ste 201 , San Rafael CA 94901-2142. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor, Behavioral Health & Social Service Providers / Psychologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor is her primary health care specialty. Lake, Susan can be contacted via phone (415) 459-5999.

Contact Information

Primary practice address
1330 Lincoln Ave Ste 201 San Rafael CA 94901-2142
Phone: (415) 459-5999
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor 225C00000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1962784488
LBN Legal business name Lake, Susan
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 10th, 2011
Last updated Dec 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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