Individual
MARK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., MFT
Contact information
Practice address
5237 COLLEGE AVE, OAKLAND, CA 94618-1414
(510) 541-0548
(510) 841-3395
Mailing address
5237 COLLEGE AVE, OAKLAND, CA 94618-1414
(510) 541-0548
(510) 841-3395
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MFC15675
CA
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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