Individual
AISHA LA SHON SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 LLEWELLYN AVE, CAMPBELL, CA 95008-1940
(408) 379-3790
Mailing address
1902 MCLAUGHLIN AVE, SAN JOSE, CA 95122-2941
(408) 292-7759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/17/2011
Last updated
12/29/2021
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