Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | CA |
NPI | 1003424029 |
---|---|
Provider Name | Anabel Juarez |
First Address | Fremont, CA 94555-1250 |
Second Address | Santa Clara, CA 95050-5485 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2020 |
Last Update Date | 16/07/2020 |