Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 12155504 | CA |
NPI | 1003575978 |
---|---|
Provider Name | Warner A Rich |
First Address | Long Beach, CA 90815-2660 |
Second Address | Hermosa Beach, CA 90254-2227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2021 |
Last Update Date | 08/12/2021 |