Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 340004BN | CA |
NPI | 1003056011 |
---|---|
Provider Name | Mrs. Samantha Nunez |
First Address | Sacramento, CA 95822-3810 |
Second Address | Sacramento, CA 95822-3810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2009 |
Last Update Date | 20/05/2013 |