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1417668344
KISTIYAPORN KERATISOMPHON
SANTA ANA, CA
NPI
1417668344
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: CA ASW111234)
Enumeration Date
2022-12-12
Last Update Date
2023-10-30
Business Address
KISTIYAPORN KERATISOMPHON ACSW
405 W 5TH ST
SANTA ANA, CA 92701-4599
Phone number: 714-834-3101
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Mailing Address
KISTIYAPORN KERATISOMPHON ACSW
9417 NAGLE AVE
ARLETA, CA 91331-5914
Phone number: 818-818-1600
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