Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | F2762859 | CA |
Y | 106S00000X | Behavior Technician |
NPI | 1003267741 |
---|---|
Provider Name | Yvette Velazquez |
First Address | Sacramento, CA 95825 |
Second Address | Sacramento, CA 95825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2016 |
Last Update Date | 21/11/2017 |