Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106E00000X | Assistant Behavior Analyst | 0-19-9728 | CA |
N | 106S00000X | Behavior Technician | CA |
NPI | 1023510682 |
---|---|
Provider Name | Gloria Gomez |
First Address | Irvine, CA 92606-2417 |
Second Address | Fresno, CA 93720-2990 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2018 |
Last Update Date | 10/05/2021 |