Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1154465821 |
---|---|
Provider Name | Kao C Syvirathphan |
First Address | Redding, CA 96049-6048 |
Second Address | Redding, CA 96001-4246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |