Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | L0412282008 | CA |
NPI | 1003005398 |
---|---|
Provider Name | Mr. Joseph B Locaria |
First Address | Fremont, CA 94536-5755 |
Second Address | Fremont, CA 94536-5755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 23/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L0412282008 | BREINING INSTITUTE (01) | CA |