Individual
SYLVIA CAROL BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PPS, LEP
Contact information
Practice address
26601 CALAROGA AVE, HAYWARD, CA 94545-3121
(510) 697-7980
Mailing address
24411 AMADOR ST, HAYWARD, CA 94544-1301
(510) 697-7980
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
LEP3244
CA
103TS0200X
School Psychologist
Primary
LEP3244
CA
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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