Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043347941 |
---|---|
Provider Name | Steven James |
First Address | Commerce, CA 90040-1348 |
Second Address | Santa Fe Springs, CA 90670-3343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 14/05/2013 |