Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | F7747193 | CA |
NPI | 1124622626 |
---|---|
Provider Name | Sarah Angelina Stewart |
First Address | Monrovia, CA 91016-3704 |
Second Address | Gardena, CA 90248-4223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2020 |
Last Update Date | 24/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F7747193 | DEPARTMENT OF MOTOR VEHICLES (01) | CA |