Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 17175 | CA |
NPI | 1003158833 |
---|---|
Provider Name | Ms. Cassandra Dobrin |
First Address | Santa Cruz, CA 95060-3030 |
Second Address | Santa Cruz, CA 95060-3030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 19/03/2013 |