Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1379 | CA |
N | 103T00000X | Psychologist | 1379 | CA |
NPI | 1013051267 |
---|---|
Provider Name | Ms. Susan Eleanor Warnock-Brooks |
First Address | Sonoma, CA 95476-7036 |
Second Address | Sonoma, CA 95476-7036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 08/07/2007 |