Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003305517 |
---|---|
Provider Name | Patricia Irazu Najera Fonseca |
First Address | Bay Point, CA 94565-2959 |
Second Address | Antioch, CA 94531-8644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2018 |
Last Update Date | 10/05/2018 |