| NPI | 1366118390 | 
|---|---|
| Other Name | JONATHAN R FARRELL | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: CA 95857)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 95857)  | 
| Enumeration Date | 2021-08-19 | 
| Last Update Date | 2023-04-04 |