Individual
AMBER SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1624 SANTA CLARA DR, ROSEVILLE, CA 95661-3554
(916) 705-9344
Mailing address
1624 SANTA CLARA DR, ROSEVILLE, CA 95661-3554
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/01/2020
Last updated
12/15/2020
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