Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY30020 | CA |
Y | 103T00000X | Psychologist | PSY30020 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1215194014 |
---|---|
Provider Name | Marta Lucia Flores |
First Address | Albany, CA 94706-1525 |
Second Address | San Rafael, CA 94901-4840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 21/10/2020 |