Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-46176 | CA |
N | 106E00000X | Assistant Behavior Analyst |
NPI | 1154898906 |
---|---|
Provider Name | Kaitlyn Tamashiro |
First Address | El Dorado Hills, CA 95762-9554 |
Second Address | El Dorado Hills, CA 95762-9554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2018 |
Last Update Date | 10/12/2020 |