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1184400285
KAYLAN LICAUSI
BERKELEY, CA
NPI
1184400285
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 117156)
Enumeration Date
2023-09-05
Last Update Date
2023-09-05
Business Address
KAYLAN LICAUSI ASW
3075 ADELINE ST STE 280
BERKELEY, CA 94703-2580
Phone number: 510-981-4100
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Mailing Address
KAYLAN LICAUSI ASW
490 LAKE PARK AVE. #16172
OAKLAND, CA 94610
Phone number: 510-914-8884
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