Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 150196262 | CA |
NPI | 1053889998 |
---|---|
Provider Name | Wanda N Harris |
First Address | Oakley, CA 94561-3502 |
Second Address | Oakley, CA 94561-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2018 |
Last Update Date | 08/11/2018 |