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Individual

ANNA LACEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7200 BANCROFT AVE STE 125C, OAKLAND, CA 94605-2454
(415) 240-1566
Mailing address
2317 FRUITVALE AVE, APT 201, OAKLAND, CA 94601-2550
(415) 240-1566

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34646
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013061555
CHILDREN'S SPECIALIZED SERVICES
CA
Enumeration date
01/22/2007
Last updated
05/02/2017
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