Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003383761 |
---|---|
Provider Name | Dolores Rocha Quinones |
First Address | San Jose, CA 95110-3441 |
Second Address | San Jose, CA 95126-3407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2018 |
Last Update Date | 30/10/2018 |