Individual
LAURA INEZ FULLWOOD-CLEGHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 64TH AVE, OAKLAND, CA 94605-1945
(510) 575-1713
Mailing address
2400 64TH AVE, OAKLAND, CA 94605-1945
(510) 575-1713
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CA
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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