Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | AMFT109963 | CA |
N | 101YP1600X | Pastoral Counselor |
NPI | 1326558453 |
---|---|
Provider Name | Velma Gwendolyn Staples-Foster |
First Address | Santa Clarita, CA 91380-7048 |
Second Address | Valencia, CA 91355-1257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2017 |
Last Update Date | 03/09/2021 |