Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083375059 |
---|---|
Provider Name | Jessica Soledad Beltran |
First Address | Los Angeles, CA 90043-1200 |
Second Address | Los Angeles, CA 90043-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2022 |
Last Update Date | 03/01/2022 |