Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | Y4860038 | CA |
NPI | 1003493172 |
---|---|
Provider Name | Vanessa Quijada-Maldonado |
First Address | Woodland Hills, CA 91367-7807 |
Second Address | Clovis, CA 93611-4432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2021 |
Last Update Date | 25/03/2021 |