Individual
EMILEE ROSE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
485 N 1ST ST, SAN JOSE, CA 95112-4067
(408) 554-2550
Mailing address
8945 GOLF LINKS RD, OAKLAND, CA 94605-4124
(510) 317-1444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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