Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ASW92393 | CA |
Y | 1041C0700X | Clinical Social Worker | 92393 | CA |
NPI | 1003441791 |
---|---|
Provider Name | Esmeralda Limon Medina |
First Address | Bakersfield, CA 93302-1000 |
Second Address | Bakersfield, CA 93301-3137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2020 |
Last Update Date | 18/09/2020 |