Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1083286645 |
---|---|
Provider Name | Iza Zazel Rueda |
First Address | Oceanside, CA 92056-4565 |
Second Address | Oceanside, CA 92056-4565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2021 |
Last Update Date | 13/07/2021 |