Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-17-7905 | CA |
NPI | 1114437308 |
---|---|
Provider Name | Sonia Cruz |
First Address | Los Angeles, CA 90043-4440 |
Second Address | San Gabriel, CA 91776-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2017 |
Last Update Date | 03/10/2017 |