Individual
AVERY TAKAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 MONTEREY HWY, SAN JOSE, CA 95110-3617
(408) 271-1730
Mailing address
1402 MONTEREY HWY, SAN JOSE, CA 95110-3617
(408) 271-1730
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
119164
CA
Other
Enumeration date
09/08/2021
Last updated
11/13/2024
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