Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS 25420 | CA |
NPI | 1003105040 |
---|---|
Provider Name | Claudia Diaz |
First Address | San Francisco, CA 94110-1908 |
Second Address | San Francisco, CA 94110-1908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2011 |
Last Update Date | 30/03/2011 |