Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | ASW 20086 | CA |
NPI | 1003007642 |
---|---|
Provider Name | Jennifer Lynn Hark |
First Address | Los Angeles, CA 90073-1003 |
Second Address | Los Angeles, CA 90073-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 08/08/2007 |