Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | 4005 | CA |
NPI | 1033324561 |
---|---|
Provider Name | Ms. Rhonda Yvonne Fugazi |
First Address | Orinda, CA 94563 |
Second Address | Walnut Creek, CA 94596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 21/10/2020 |