Provider Demographics
NPI:1386208296
Name:HOYLE, LAWANDA ALANA (ACSW)
Entity Type:Individual
Prefix:
First Name:LAWANDA
Middle Name:ALANA
Last Name:HOYLE
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:LAWANDA
Other - Middle Name:ALANA
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACSW
Mailing Address - Street 1:4001 S WATT AVE APT 64
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-4478
Mailing Address - Country:US
Mailing Address - Phone:661-794-3830
Mailing Address - Fax:
Practice Address - Street 1:2750 SUTTERVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1093
Practice Address - Country:US
Practice Address - Phone:916-475-7351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83306104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker