Provider Demographics
NPI:1740941061
Name:CLYMER, LUCIA GRAUMAN (LCSW)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:GRAUMAN
Last Name:CLYMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LUCIA
Other - Middle Name:
Other - Last Name:GRAUMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5464 COLLEGE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1687
Mailing Address - Country:US
Mailing Address - Phone:917-664-3724
Mailing Address - Fax:
Practice Address - Street 1:5464 COLLEGE AVE STE C
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1687
Practice Address - Country:US
Practice Address - Phone:415-820-9664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-08
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS267181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical