Individual
MISS ALAETRA JENEESE DORSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHRS, BA, MA
Contact information
Practice address
232 E GISH RD, SAN JOSE, CA 95112-4706
(408) 876-4185
Mailing address
3611 WILLOWVIEW DR, SAN JOSE, CA 95118-1361
(408) 266-7629
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3411
COUNTY ID
CA
Enumeration date
11/16/2006
Last updated
07/08/2007
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