Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-52432 | CA |
N | 106S00000X | Behavior Technician |
NPI | 1003439571 |
---|---|
Provider Name | Ana Karen Pavia |
First Address | Ontario, CA 91764-4802 |
Second Address | Ontario, CA 91764-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2020 |
Last Update Date | 13/10/2021 |