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Individual
SHURENE LARAE PREMO
Active
Individual
SHURENE LARAE PREMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
99213
CA
104100000X
Social Worker
99213
CA
1041C0700X
Clinical Social Worker
Primary
141912
CA
1041C0700X
Clinical Social Worker
99213
CA
Other
Enumeration date
10/05/2022
Last updated
09/16/2026
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