Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1083072821 |
---|---|
Provider Name | Sharonda Capers |
First Address | San Pedro, CA 90731-2830 |
Second Address | San Pedro, CA 90731-2830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2016 |
Last Update Date | 08/02/2016 |