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1700011202
GENA H NINIVAGGIO
VACAVILLE, CA
NPI
1700011202
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS21793)
Enumeration Date
2009-05-27
Last Update Date
2011-08-09
Business Address
-- GENA H NINIVAGGIO LCSW
1600 CALIFORNIA DR
VACAVILLE, CA 95687
Phone number: 707-448-6841
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Mailing Address
-- GENA H NINIVAGGIO LCSW
PO BOX 5401
WALNUT CREEK, CA 94596-1401
Phone number: 707-317-3208
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