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ALEXANDER SULLIVAN PROVDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
5377 LOCKSLEY AVE, OAKLAND, CA 94618-1122
(510) 304-3328
(510) 654-4792
Mailing address
5377 LOCKSLEY AVE, OAKLAND, CA 94618-1122
(510) 304-3328
(510) 654-4792

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
148702
CA

Other

Enumeration date
10/02/2024
Last updated
10/02/2024
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