Guadalupe Veronica De Santos

Individual provider Active NPI Behavior Technician · Walnut Park, CA

NPI 1275036675 · NPPES record last updated Mar 12, 2018

Key facts

NPI
1275036675
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
7400 Pacific Blvd Ste a&B
Walnut Park, CA 90255-5739
Phone
(323) 538-9050
NPI assigned
Mar 12, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

7400 Pacific Blvd Ste a&B
Walnut Park, CA 90255-5739

Mailing address

7400 Pacific Blvd Ste a&B
Walnut Park, CA 90255-5739
Phone (323) 538-9050

Other providers in Walnut Park, CA

All providers in Walnut Park, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.