Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | LCSW72302 | CA |
NPI | 1003149956 |
---|---|
Provider Name | Mrs. Yvette Adriana Rodriguez Jara |
First Address | Monrovia, CA 91016-6204 |
Second Address | Duarte, CA 91010-2567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2009 |
Last Update Date | 29/03/2017 |