Merlissa Ann A Agustin
Behavior Analyst in San Jose, CA. Individual provider (NPI-1).
NPI number1730681016
StatusActive
Last updated in NPPESMay 19, 2025
Details
- NPI
- 1730681016
- Entity type
- Individual (NPI-1)
- Name
- Merlissa Ann A Agustin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2018
- Certification date
- May 19, 2025
- Last updated
- May 19, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | CA | Yes |
| 103K00000X | Behavior Analyst | BACB540686 | CA | |
| 103K00000X | Behavior Analyst | – | – | |
| 106S00000X | Behavior Technician | – | – |
Practice location
3610 Snell AveSan Jose, CA 95136-1305
Phone 408-281-6950
Mailing address
1025 Atlantic Ave Ste 101Alameda, CA 94501-1188
Phone 510-268-8120
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