Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-20-119932 | CA |
NPI | 1003420357 |
---|---|
Provider Name | Esther Xie |
First Address | Modesto, CA 95355-1582 |
Second Address | Torrance, CA 90501-1479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2020 |
Last Update Date | 03/09/2020 |