Susana Tavera Gomez
Behavior Technician in Stockton, CA. Individual provider (NPI-1).
NPI number1467167643
StatusActive
Last updated in NPPESJan 30, 2023
Details
- NPI
- 1467167643
- Entity type
- Individual (NPI-1)
- Name
- Susana Tavera Gomez
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 23, 2023
- Certification date
- Jan 30, 2023
- Last updated
- Jan 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
| 106E00000X | Assistant Behavior Analyst | – | CA |
Practice location
1811 Grand Canal Blvd Ste 2Stockton, CA 95207-8107
Phone 877-418-2978
Mailing address
350 Fairway Dr Ste 101Deerfield Beach, FL 33441-1834
Phone 877-418-2978 · Fax 866-500-2186
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All 3,125 Behavior Technician providers in Stockton · All 11,041 providers in Stockton
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