Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003371360 |
---|---|
Provider Name | Erika Rivera |
First Address | Fountain Valley, CA 92708-8201 |
Second Address | Fountain Valley, CA 92708-8201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2019 |
Last Update Date | 12/01/2021 |