Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 4885 | FL |
NPI | 1013271139 |
---|---|
Provider Name | Ms. Tracey Lynne Silveira-Zaldivar |
First Address | Lake Forest, CA 92630-5515 |
Second Address | Brea, CA 92821-5312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2012 |
Last Update Date | 03/07/2012 |