Evangeline Tan
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1063973311
StatusActive
Last updated in NPPESMar 28, 2019
Details
- NPI
- 1063973311
- Entity type
- Individual (NPI-1)
- Name
- Evangeline Tan
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2019
- Last updated
- Mar 28, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
4719 Viewridge Ave Ste 100San Diego, CA 92123-1685
Phone 866-727-8274
Mailing address
4719 Viewridge Ave Ste 100San Diego, CA 92123-1685
Phone 866-727-8274
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