Martha Paola De Anda

Individual provider Active NPI Assistant Behavior Analyst · Imperial, CA

NPI 1871256362 · NPPES record last updated Oct 20, 2021

Key facts

NPI
1871256362
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
Practice address
629 Garnet St
Imperial, CA 92251-2516
Phone
(760) 890-8681
NPI assigned
Oct 20, 2021
Sex
Female
Sole proprietor
No

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
Assistant Behavior Analyst 106E00000X Yes

Addresses

Primary practice location

629 Garnet St
Imperial, CA 92251-2516

Mailing address

629 Garnet St
Imperial, CA 92251-2516
Phone (760) 890-8681

Other providers in Imperial, CA

All providers in Imperial, CA · Assistant Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.