Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | ASW85991 | CA |
N | 1041S0200X | School Social Worker |
NPI | 1003306549 |
---|---|
Provider Name | Fernanda Obeso |
First Address | Rosemead, CA 91770-3414 |
Second Address | Rosemead, CA 91770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2018 |
Last Update Date | 13/08/2019 |