Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCSW82855 | CA |
NPI | 1003224130 |
---|---|
Provider Name | Adriana Castro Soriano |
First Address | Phillips Ranch, CA 91766-4905 |
Second Address | Norco, CA 92860-3628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2014 |
Last Update Date | 13/08/2020 |