Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | CA |
NPI | 1003374810 |
---|---|
Provider Name | Nallely Guadalupe Marquez Zapata |
First Address | Concord, CA 94519-2572 |
Second Address | San Mateo, CA 94401-1653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2019 |
Last Update Date | 11/03/2019 |