Individual
MR. GARO SOEUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW STUDENT
Contact information
Practice address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 601-0203
Mailing address
3200 ADELINE ST, BERKELEY, CA 94703-2407
(510) 601-0203
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
CA
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D9848984
MENTAL HEALTH SERVICES
CA
Enumeration date
11/03/2022
Last updated
11/03/2022
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