Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003052036 |
---|---|
Provider Name | Patricia L Davidson |
First Address | Hayward, CA 94541-1942 |
Second Address | Newark, CA 94560-3734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2008 |
Last Update Date | 22/12/2008 |