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1861747552
JASEON S. OUTLAW
SAN LEANDRO, CA
NPI
1861747552
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY23676)
Enumeration Date
2012-07-18
Last Update Date
2016-03-29
Business Address
Dr. JASEON S. OUTLAW PhD
13847 E 14TH ST STE 202
SAN LEANDRO, CA 94578-2626
Phone number: 510-463-1302
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Mailing Address
Dr. JASEON S. OUTLAW PhD
13847 E 14TH ST STE 202
SAN LEANDRO, CA 94578-2626
Phone number: 510-463-1302
Copy
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