Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-16-7406 | CA |
NPI | 1093250300 |
---|---|
Provider Name | Eva Sheridan |
First Address | San Francisco, CA 94103-5424 |
Second Address | San Francisco, CA 94103-5424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2016 |
Last Update Date | 21/12/2016 |