Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003105784 |
---|---|
Provider Name | Dr. Lina Kogan |
First Address | San Diego, CA 92126-2364 |
Second Address | San Diego, CA 92126-2364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2011 |
Last Update Date | 01/04/2011 |