| NPI | 1588796148 |
|---|---|
| Former Name | AUDRA JO PENAFLORIDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW 26550) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW20787) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2011-07-01 |