Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003218983 |
---|---|
Provider Name | Jenifer Castaneda |
First Address | Hayward, CA 94541-3410 |
Second Address | Hayward, CA 94541-3410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2014 |
Last Update Date | 22/09/2014 |