Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CA |
NPI | 1003168220 |
---|---|
Provider Name | Tina Howerton |
First Address | Fremont, CA 94538-4390 |
Second Address | Fremont, CA 94538-4390 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2012 |
Last Update Date | 11/10/2012 |