Search › California › 1041C0700X
Allen Lake, LCSW
NPI 1972866721 · on the registry since 2012 · sole proprietor
Practice
- Address
- 110 E D St Ste J
Benicia, CA 94510 - Phone
- (707) 413-7680
- Clinicians at this address
- 2
Additional practice sites
- 1735 Enterprise Dr Ste 105a, Fairfield, CA
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YM0800X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-03-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California