Individual provider · Type 1 NPI
Alyssa Amber Lake
Addiction (Substance Use Disorder) Counselor · San Rafael, CA
NPI number
1124504089
Active
Practice location
800 A St
San Rafael, CA 94901-3011
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Technician | 106S00000X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | RT1453390826 (CA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1124504089
Alyssa Amber Lake's National Provider Identifier is 1124504089, issued on Jul 13, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Rafael, CA. The record was last updated on Sep 17, 2026.