Individual
MISS LA'SHAY ANTIONETTE FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 HARVEY DR APT 234, WALNUT CREEK, CA 94597-3603
(510) 300-7552
Mailing address
1001 HARVEY DR, WALNUT CREEK, CA 94597-3609
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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