| Doctor Name: | MS. LA VONNE LORRAINE OTIS-TOEHAY PRADO |
| NPI Number: | 1629006564 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC II, IMFT |
| License Number: | |
| Business Practice Address: | Indian Health Council Clinic 50100 Golsh Rd Valley Center, CA - 92082 |
| Business Phone Number: | 7607491410 |
| Business Fax Number: | 7607493347 |
| Mailing Address: | 9760 Marilla Dr, # 16 LAKESIDE |
| State: | CA |
| Postal Code: | 920402821 |
| Phone Number: | 7607491410 |
| Fax Number: | 7607493347 |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |