Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | D5307017 | CA |
NPI | 1003392960 |
---|---|
Provider Name | Sakeena Alexis Sims |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Long Beach, CA 90807-4430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2018 |
Last Update Date | 13/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
91856252C87177 | (05) | CA |