Jezzika Rouj Diaz
Behavior Technician in San Bruno, CA. Individual provider (NPI-1).
NPI number1831842467
StatusActive
Last updated in NPPESFeb 2, 2022
Details
- NPI
- 1831842467
- Entity type
- Individual (NPI-1)
- Name
- Jezzika Rouj Diaz
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 2, 2022
- Certification date
- Feb 2, 2022
- Last updated
- Feb 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
901 Sneath Ln Ste 105San Bruno, CA 94066-2415
Phone 855-223-7123 · Fax 714-784-7516
Mailing address
16782 Von Karman Ave Ste 11Irvine, CA 92606-2417
Phone 855-223-7123 · Fax 714-784-7516
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