Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003282799 |
---|---|
Provider Name | Vanessa Cofresi |
First Address | El Sobrante, CA 94803-3222 |
Second Address | El Sobrante, CA 94803-3222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2015 |
Last Update Date | 17/08/2015 |