Individual
ALICIA SANDOVAL GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
124 MAIN ST, ROSEVILLE, CA 95678-2232
(916) 724-5089
Mailing address
124 MAIN ST, ROSEVILLE, CA 95678-2232
(916) 724-5089
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
65466
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/16/2021
Last updated
09/12/2022
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