Individual
ROBERT J. SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1735 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-3718
(530) 541-4111
Mailing address
1735 LAKE TAHOE BLVD, SOUTH LAKE TAHOE, CA 96150-3718
(530) 541-4111
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
240083382
CA
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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