Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1184800401 |
---|---|
Provider Name | Diego Ojeda |
First Address | Brawley, CA 92227-2253 |
Second Address | Brawley, CA 92227-2253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2008 |
Last Update Date | 16/01/2008 |