Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | CA |
NPI | 1104442169 |
---|---|
Provider Name | Sydney Marie Baron |
First Address | Modesto, CA 95352-5157 |
Second Address | Folsom, CA 95630-4045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2020 |
Last Update Date | 24/06/2020 |