Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003066358 |
---|---|
Provider Name | Adriana Guadalupe Frias |
First Address | San Leandro, CA 94578-1132 |
Second Address | Concord, CA 94518-3225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2008 |
Last Update Date | 23/09/2008 |