Individual
STACEY LILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 ALMA AVE, CASTRO VALLEY, CA 94546-3104
(510) 364-6591
Mailing address
15638 ATLANTUS AVE, SAN LEANDRO, CA 94579-2710
(510) 364-6591
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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