Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003129602 |
---|---|
Provider Name | Kymberly Agresti |
First Address | San Francisco, CA 94102-4801 |
Second Address | San Francisco, CA 94117-1008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2010 |
Last Update Date | 19/10/2016 |