Search › California › 363LA2100X
Stayce Sullivan
NPI 1770139123 · on the registry since 2019
Practice
- Address
- 515 Northgate Dr.
Ste. 101
San Rafael, CA 94903 - Phone
- (415) 202-9990
- Fax
- (415) 202-0102
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-08-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California