Individual provider · NPI-1

Jalisa Monique Banks

Social Worker, Clinical · Mountain View, CA

NPI number1154088516
StatusActive
Last updated in NPPESMar 13, 2023

Details

NPI
1154088516
Entity type
Individual (NPI-1)
Name
Jalisa Monique Banks
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 19, 2021
Certification date
Dec 10, 2021
Last updated
Mar 13, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalLC2000030–Yes

Practice location

990 Villa St
Mountain View, CA 94041-1236

Phone 000-000-0000

Mailing address

990 Villa St
Mountain View, CA 94041-1236

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