Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS6610 | CA |
NPI | 1003011503 |
---|---|
Provider Name | Ms. Sonya None Starr |
First Address | San Diego, CA 92153-0219 |
Second Address | San Diego, CA 92154-8404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |