Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1023609500 |
---|---|
Provider Name | Priscilla G Valencia |
First Address | Thousand Oaks, CA 91360-4265 |
Second Address | Thousand Oaks, CA 91360-4265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2021 |
Last Update Date | 28/01/2021 |