Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1063993426 |
---|---|
Provider Name | Esmeralda Cruz Arreguin |
First Address | Santa Rosa, CA 95407-6318 |
Second Address | Vallejo, CA 94590-5962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 23/08/2018 |