Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS27255 | CA |
NPI | 1003177742 |
---|---|
Provider Name | Mrs. Janelle Jensen Goh |
First Address | Bakersfield, CA 93301-3506 |
Second Address | Bakersfield, CA 93301-3506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2012 |
Last Update Date | 30/05/2012 |