Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | R1381470320 | CA |
NPI | 1003439209 |
---|---|
Provider Name | Azitta Hekmati |
First Address | San Francisco, CA 94103-4285 |
Second Address | San Francisco, CA 94124-3277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2020 |
Last Update Date | 21/05/2020 |