| NPI | 1619482155 |
|---|---|
| Former Name | LISA SANDOVAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 118274) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW79240) |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW79240) | |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2023-10-05 |