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General NPI Number Information
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NPI Number | 1952856288
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Entity Type | Individual
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Provider Name | LACEY XEPOLEAS PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 4155 BLACKHAWK PLAZA CIR STE 101
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City | DANVILLE
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State | CA
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Zip | 94506-4829
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Country | US
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Telephone | 925-984-2326
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Fax |
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Provider Business Mailing Address
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Address Line | 1170 BRIONES RD
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City | MARTINEZ
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State | CA
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Zip | 94553-9766
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Country | US
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Telephone | 925-392-4003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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