Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003388950 |
---|---|
Provider Name | Adriana Castellanos |
First Address | Sacramento, CA 95826-9716 |
Second Address | Sacramento, CA 95826-9716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2018 |
Last Update Date | 17/12/2018 |