Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003349192 |
---|---|
Provider Name | Rosalba Roxanne Caandoy |
First Address | San Diego, CA 92160-9001 |
Second Address | San Diego, CA 92108-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2017 |
Last Update Date | 10/03/2020 |