Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 22485 | CA |
NPI | 1003156563 |
---|---|
Provider Name | Mr. William Shapiro |
First Address | Anaheim, CA 92807-3405 |
Second Address | Corona, CA 92880-9508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2013 |
Last Update Date | 21/02/2013 |