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Individual

FAANUU SEUMANUTUSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
275 BECK AVE, FAIRFIELD, CA 94533-6804
(707) 784-8017
Mailing address
PO BOX 5621, VALLEJO, CA 94591-0621

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
Primary
127639
CA
1041C0700X
Clinical Social Worker
TEST
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982075537
CA
Enumeration date
10/08/2015
Last updated
03/04/2025
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