Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | CA | |
N | 106E00000X | Assistant Behavior Analyst | ||
N | 106S00000X | Behavior Technician | CA |
NPI | 1053827998 |
---|---|
Provider Name | Ixtlaly Shayeste Sanchez |
First Address | Temecula, CA 92591-4659 |
Second Address | Temecula, CA 92591-4659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2017 |
Last Update Date | 03/08/2021 |