Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CX0006X | Orientation and Mobility Training Provider | ||
Y | 225CX0006X | Orientation and Mobility Training Provider | R1286240118 | CA |
NPI | 1720596190 |
---|---|
Provider Name | Sasha Contreras |
First Address | San Jose, CA 95131-2007 |
Second Address | San Jose, CA 95131-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2018 |
Last Update Date | 25/11/2018 |