Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCS21278 | CA |
N | 101YM0800X | Mental Health Counselor | LCS21278 | CA |
Y | 1041C0700X | Clinical Social Worker | LCS21278 | CA |
NPI | 1003241787 |
---|---|
Provider Name | Virginia A. Horton |
First Address | Modesto, CA 95355-8929 |
Second Address | Modesto, CA 95355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2013 |
Last Update Date | 12/09/2013 |