Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003034117 |
---|---|
Provider Name | Rufina Sandoval |
First Address | Visalia, CA 93277-9394 |
Second Address | Porterville, CA 93257-4871 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 29/06/2011 |