Individual
GARY MICHAEL LEACH LAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
510 E MAGNOLIA ST STE 100, STOCKTON, CA 95202-1850
(209) 938-0831
(209) 938-0849
Mailing address
7414 SHOREHAM PL, STOCKTON, CA 95207-1229
(209) 938-0831
(209) 938-0849
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW93379
CA
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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