Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-49596 | CA |
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1053998450 |
---|---|
Provider Name | Irena Espana |
First Address | Los Angeles, CA 90010-3537 |
Second Address | West Covina, CA 91790-2938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2021 |
Last Update Date | 05/05/2021 |