Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1316319775 |
---|---|
Provider Name | Ms. Johanna Murillo |
First Address | Temecula, CA 92592-3926 |
Second Address | Temecula, CA 92592-3926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2015 |
Last Update Date | 07/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1316319775 | (05) | CA |