Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YM0800X | Mental Health Counselor | 89316 | CA |
NPI | 1003330705 |
---|---|
Provider Name | Amber Mckinney |
First Address | San Diego, CA 92101-5504 |
Second Address | San Diego, CA 92101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2017 |
Last Update Date | 25/06/2019 |