Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS17971 | CA |
NPI | 1003069816 |
---|---|
Provider Name | Stacey Sigman |
First Address | Pomona, CA 91767-2774 |
Second Address | El Monte, CA 91732-3740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2008 |
Last Update Date | 24/10/2008 |