Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | CA |
NPI | 1124501929 |
---|---|
Provider Name | Monica Christina Lopez |
First Address | Tracy, CA 95377-7928 |
Second Address | Tracy, CA 95377-7928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2018 |
Last Update Date | 08/09/2018 |