Individual
DR. LAURA JEAN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
100 PRISON RD, REPRESA, CA 95671-3000
(916) 985-8610
Mailing address
PO BOX 6781, FOLSOM, CA 95763-6781
(916) 985-8610
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
PSY 22206
CA
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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