Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 94494 | CA |
NPI | 1003304775 |
---|---|
Provider Name | Mrs. Sandra Louise James |
First Address | Los Angeles, CA 90057-3119 |
Second Address | Los Angeles, CA 90057-3119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2018 |
Last Update Date | 14/09/2020 |