Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003311879 |
---|---|
Provider Name | Rachelle Mitzi Franco Bautista |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Fremont, CA 94538-1456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2018 |
Last Update Date | 26/03/2018 |