Individual
BREANNA NICOLE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
301 VICTORIA ST, COSTA MESA, CA 92627-7131
(949) 642-2734
Mailing address
7350 KIRKWOOD PL, HIGHLAND, CA 92346-6224
(909) 838-1534
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
CA
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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