LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC. NPI 1255897757

NPI Information

  • NPI: 1255897757
  • Provider Name: LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
  • Classification: Psychologist - 103TA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 4505 PRECISSI LN STE A
    STOCKTON, CA
    ZIP 95207
  • Phone: (209) 425-3815

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NPI Details

LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. is an addiction (substance use disorder) psychologist in Stockton, CA. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC. NPI is 1255897757. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4505 PRECISSI LN STE A
STOCKTON, CA
ZIP 95207-240
Phone: (209) 425-3815
Fax: (209) 451-0704

The provider's authorized official is Amy D'amato .
The authorized official title is Contracts Manager and has the following contact phone number (805) 264-3388.

The enumeration date for this NPI number is 2/20/2019 and was last updated on 2/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalNo
2163WP0808XRegistered NursePsychiatric/Mental HealthNo
3103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

What is NPI?

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This page was last updated on: 3/30/2025

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