Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 01-042273 | CA |
NPI | 1003010422 |
---|---|
Provider Name | Bernadette Bernice Oakes |
First Address | Sacramento, CA 95823-1865 |
Second Address | Sacramento, CA 95823-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 08/07/2007 |