Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | 101Y00000X | CA |
NPI | 1063778264 |
---|---|
Provider Name | Hagikah Victoria Birden |
First Address | San Francisco, CA 94116-2923 |
Second Address | San Francisco, CA 94116-2923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2012 |
Last Update Date | 02/04/2012 |