Individual
JILL MCCULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 GORDON LN, SANTA ROSA, CA 95404-5636
(707) 527-3249
Mailing address
300 STONY POINT RD APT 190, SANTA ROSA, CA 95401-5960
(707) 490-7962
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
08/07/2025
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