Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | CA |
NPI | 1013305416 |
---|---|
Provider Name | Raegan Delgado |
First Address | Ventura, CA 93003-7783 |
Second Address | Ventura, CA 93003-7783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2015 |
Last Update Date | 07/01/2015 |