Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1538595608 |
---|---|
Provider Name | Clavia Vlass |
First Address | Walnut Creek, CA 94598-3647 |
Second Address | San Francisco, CA 94116-2923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2013 |
Last Update Date | 28/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13561705 | KAISER (01) | CA |