Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 102L00000X | Psychologist | 31452 | CA |
Y | 103T00000X | Psychologist | 31452 | CA |
NPI | 1003122854 |
---|---|
Provider Name | Ms. Shadavia France |
First Address | Oakland, CA 94612-1520 |
Second Address | Oakland, CA 94612-1520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2010 |
Last Update Date | 23/08/2021 |