Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ASW22920 | CA |
NPI | 1003240896 |
---|---|
Provider Name | Mrs. Baljit Dhanjal Nagi |
First Address | Santa Clara, CA 95050-4137 |
Second Address | Santa Clara, CA 95050-4137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2013 |
Last Update Date | 28/08/2013 |