Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1295971166 |
---|---|
Provider Name | Pernell Swahili - El |
First Address | San Diego, CA 92123-3743 |
Second Address | San Diego, CA 92117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2008 |
Last Update Date | 30/05/2018 |