Christabel Samantha Utama
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1669196531
StatusActive
Last updated in NPPESOct 3, 2022
Details
- NPI
- 1669196531
- Entity type
- Individual (NPI-1)
- Name
- Christabel Samantha Utama
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2022
- Certification date
- Oct 3, 2022
- Last updated
- Oct 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
3111 Camino Del Rio N Ste 400San Diego, CA 92108-5724
Phone 888-922-2843 · Fax 855-568-2494
Mailing address
3111 Camino Del Rio N Ste 400San Diego, CA 92108-5724
Phone 888-922-2843 · Fax 855-568-2494
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