Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | CA | |
Y | 106E00000X | Assistant Behavior Analyst | CA | |
N | 106S00000X | Behavior Technician | CA |
NPI | 1083225254 |
---|---|
Provider Name | Jose Alfredo Guzman |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Davis, CA 95618-4882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2020 |
Last Update Date | 12/08/2020 |