Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003384942 |
---|---|
Provider Name | Chelsea J Ross |
First Address | Richmond, CA 94806-2660 |
Second Address | Irvine, CA 92614-6234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2018 |
Last Update Date | 08/11/2018 |