Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003374539 |
---|---|
Provider Name | Jasmine Elizabeth Flores |
First Address | Fresno, CA 93711-1582 |
Second Address | Fresno, CA 93706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2019 |
Last Update Date | 04/03/2019 |