| NPI | 1174993604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95006428) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 78207) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: CA 716641) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA 78207) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 363L00000X Nurse Practitioner (Licence: CA 95006428) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 1099329) | |
| Enumeration Date | 2015-09-27 |
| Last Update Date | 2025-03-11 |