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1962220483
ALEXANDER SULLIVAN PROVDA
OAKLAND, CA
NPI
1962220483
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 148702)
Enumeration Date
2024-10-02
Last Update Date
2024-10-02
Business Address
ALEXANDER SULLIVAN PROVDA LMFT
5377 LOCKSLEY AVE
OAKLAND, CA 94618-1122
Phone number: 510-304-3328
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Mailing Address
ALEXANDER SULLIVAN PROVDA LMFT
5377 LOCKSLEY AVE
OAKLAND, CA 94618-1122
Phone number: 510-304-3328
Copy
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