Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003170911 |
---|---|
Provider Name | Taufaga Ilaoa-Taupau |
First Address | San Diego, CA 92101-1250 |
Second Address | San Diego, CA 92101-1250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 28/05/2014 |