Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003393117 |
---|---|
Provider Name | Ana Salamanca |
First Address | Walnut Grove, CA 95690-0442 |
Second Address | Elk Grove, CA 95758-8013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2018 |
Last Update Date | 20/07/2018 |