Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | R1196180315 | CA |
NPI | 1003391103 |
---|---|
Provider Name | Karen Yvette Price |
First Address | Oakland, CA 94605-4534 |
Second Address | Hayward, CA 94544-7245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2018 |
Last Update Date | 25/09/2018 |