Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003311762 |
---|---|
Provider Name | Melissa Mendez Padilla |
First Address | Fresno, CA 93705-2701 |
Second Address | San Ramon, CA 94583-1641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2018 |
Last Update Date | 26/03/2018 |