Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1295332955 |
---|---|
Provider Name | Mrs. Juana Echeveste-Davis I |
First Address | Clovis, CA 93611-3078 |
Second Address | Fresno, CA 93710-5924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2020 |
Last Update Date | 06/10/2020 |