| NPI | 1255859963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW104138) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW80175) |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW80175) | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker (Licence: CA 104138) | |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2023-06-02 |