Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-17-7910 | CA |
NPI | 1033608658 |
---|---|
Provider Name | Lorena Vera |
First Address | San Francisco, CA 94103-2485 |
Second Address | Sacramento, CA 95814-1808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2018 |
Last Update Date | 09/05/2018 |