Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 106S00000X | Behavior Technician | RBT-16-18696 | CA |
NPI | 1003323551 |
---|---|
Provider Name | Sydney Nishida |
First Address | Glendale, CA 91208-2533 |
Second Address | Longmont, CO 80501-3310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2018 |
Last Update Date | 27/12/2021 |