| NPI | 1639538556 |
|---|---|
| Former Name | JEANETTE FAMOSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 83470) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2016-02-20 |
| Last Update Date | 2023-02-14 |