Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | F4361160 | CA |
N | 106E00000X | Assistant Behavior Analyst | F4361160 | CA |
N | 106S00000X | Behavior Technician | F431160 | CA |
NPI | 1104397165 |
---|---|
Provider Name | Desiree Rene Castaneda |
First Address | Ventura, CA 93003-6620 |
Second Address | Ventura, CA 93003-6620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2018 |
Last Update Date | 16/12/2018 |