Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003384272 |
---|---|
Provider Name | Eliseo Torres |
First Address | Sacramento, CA 95826-2481 |
Second Address | Citrus Heights, CA 95621-1741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2018 |
Last Update Date | 06/11/2018 |