Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003018664 |
---|---|
Provider Name | Jill Marie Stonerock |
First Address | Los Angeles, CA 90027-1434 |
Second Address | Los Angeles, CA 90042-1245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |