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1265594113
STACEY NELSON CLEMENCEAU
SAN RAFAEL, CA
NPI
1265594113
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Former Name
STACEY NELSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY16162)
Enumeration Date
2006-12-15
Last Update Date
2022-02-11
Business Address
Dr. STACEY NELSON CLEMENCEAU Ph.D.
820 LAS GALLINAS AVE
SAN RAFAEL, CA 94903-3410
Phone number: 415-444-3522
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Mailing Address
Dr. STACEY NELSON CLEMENCEAU Ph.D.
820 LAS GALLINAS AVE
SAN RAFAEL, CA 94903-3410
Phone number: 415-444-3522
Copy
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