Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY#23782 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY#23782 | CA |
NPI | 1013089945 |
---|---|
Provider Name | Susanna Farina |
First Address | Represa, CA 95671-3000 |
Second Address | Represa, CA 95671-3010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/10/2018 |