Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND351 | CA |
NPI | 1003046533 |
---|---|
Provider Name | Tara Justine Stoop |
First Address | Oakland, CA 94605-4623 |
Second Address | Oakland, CA 94609-3556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2009 |
Last Update Date | 17/07/2009 |