Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1164991071 |
---|---|
Provider Name | Christopher Michael Vasquez |
First Address | San Jose, CA 95123-6421 |
Second Address | San Jose, CA 95128-1150 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2018 |
Last Update Date | 20/11/2018 |