Individual
EGDA HARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3270 KERNER BLVD STE B, SAN RAFAEL, CA 94901-4840
(415) 473-3783
Mailing address
3270 KERNER BLVD STE B, SAN RAFAEL, CA 94901-4840
(415) 473-3783
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
11/07/2016
Last updated
12/07/2020
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