Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1023526159 |
---|---|
Provider Name | Brenda Naralie Ortiz |
First Address | Irvine, CA 92617-4353 |
Second Address | Santa Ana, CA 92706-1458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2018 |
Last Update Date | 10/01/2018 |