Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | F3265520 | CA |
NPI | 1003387887 |
---|---|
Provider Name | Jasmine Elena Calles |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Ontario, CA 91764-5449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2018 |
Last Update Date | 05/12/2018 |