Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor |
NPI | 1003260092 |
---|---|
Provider Name | Stephanee Gomez Vera |
First Address | Sacramento, CA 95824 |
Second Address | Sacramento, CA 95670-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2016 |
Last Update Date | 27/11/2018 |