Individual
DR. GEORGINA INES LAMPHERE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8253 WHITE OAK AVE, RANCHO CUCAMONGA, CA 91730-7671
(909) 987-1997
(909) 978-0993
Mailing address
8253 WHITE OAK AVE, RANCHO CUCAMONGA, CA 91730-7671
(909) 987-1997
(909) 978-0993
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 10649
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY 10649
PH.D. LICENSE
CA
Enumeration date
01/16/2006
Last updated
05/20/2019
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