Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | P0404200933 | CA |
NPI | 1013036136 |
---|---|
Provider Name | Vickie Plainfield |
First Address | Santa Cruz, CA 95060-1900 |
Second Address | Santa Cruz, CA 95060-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |