Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | ||
Y | 103G00000X | Clinical Psychologist | PSY25881 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY25881 | CA |
N | 225400000X | Rehabilitation Practitioner | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1053568253 |
---|---|
Provider Name | Dr. Serena Christine Galloway |
First Address | South Gate, CA 90280-1270 |
Second Address | Whittier, CA 90605-2156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2008 |
Last Update Date | 08/08/2021 |