Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 33517 | CA |
NPI | 1003242553 |
---|---|
Provider Name | Ana L Vazquez |
First Address | Newhall, CA 91321-2500 |
Second Address | Newhall, CA 91321-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2013 |
Last Update Date | 16/09/2013 |