Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1023516978 |
---|---|
Provider Name | Erika Egbert |
First Address | Buena Park, CA 90620-1617 |
Second Address | Gardena, CA 90248-4223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2018 |
Last Update Date | 25/01/2018 |