Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003371949 |
---|---|
Provider Name | Anayely Loaiza |
First Address | Fullerton, CA 92835-4105 |
Second Address | Los Angeles, CA 90067-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2019 |
Last Update Date | 26/04/2021 |