Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS16618 | CA |
NPI | 1003024555 |
---|---|
Provider Name | Ms. Norma Zapata |
First Address | Rancho Cucamonga, CA 91730-1163 |
Second Address | Pasadena, CA 91103-1620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LCS16618 | LICENSE NUMBER (01) | CA |