Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003379389 |
---|---|
Provider Name | Daisy Medrano |
First Address | Salinas, CA 93906-3514 |
Second Address | Salinas, CA 93906-3514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2019 |
Last Update Date | 21/07/2021 |