Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003407313 |
---|---|
Provider Name | Concepcion J Garcia |
First Address | Upland, CA 91786-3455 |
Second Address | Rancho Cucamonga, CA 91730-5838 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2021 |
Last Update Date | 29/01/2021 |