Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | CA | |
N | 106E00000X | Assistant Behavior Analyst | NONE | CA |
NPI | 1154826030 |
---|---|
Provider Name | Brandon Quoc Dinh |
First Address | Corona, CA 92882-3633 |
Second Address | Corona, CA 92882-3633 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2018 |
Last Update Date | 24/03/2018 |