Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | CA | |
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | F0703291121 | CA |
N | 101YP1600X | Pastoral Counselor | CA |
NPI | 1174945216 |
---|---|
Provider Name | Tommy French |
First Address | Riverside, CA 92509-8136 |
Second Address | Riverside, CA 92509-8136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2014 |
Last Update Date | 08/01/2014 |