Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1003125303 |
---|---|
Provider Name | Jeneve Kanaventi |
First Address | Commerce, CA 90022-5103 |
Second Address | Commerce, CA 90022-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2010 |
Last Update Date | 03/08/2016 |