Individual ProviderLisa Ann KullyMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address5661 Keith Ave, Suite 201, Oakland, CA 94618-1542(510) 601-7980PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Ann Kully does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1316145907Provider TypeIndividualFull NameKully, Lisa AnnTitleMs.CredentialMFTGenderFemaleSole ProprietorYesEnumeration Date7/5/2007Last Updated8/9/2010Contact InformationPractice LocationPractice Address5661 Keith Ave, Suite 201, Oakland, CA 94618-1542Phone(510) 601-7980FaxUnlisted FaxMailing LocationMailing Address5661 Keith Avenue, Suite 201, Oakland, CA 94618-1542Phone(510) 601-7980FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC37282California