Desiree Ava Lugo
Behavior Technician in Stockton, CA. Individual provider (NPI-1).
NPI number1871199554
StatusActive
Last updated in NPPESDec 8, 2020
Details
- NPI
- 1871199554
- Entity type
- Individual (NPI-1)
- Name
- Desiree Ava Lugo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 8, 2020
- Certification date
- Dec 8, 2020
- Last updated
- Dec 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | CA | Yes |
Practice location
1811 Grand Canal BlvdStockton, CA 95207-8107
Phone 209-213-1124
Mailing address
1811 Grand Canal BlvdStockton, CA 95207-8107
Phone 209-213-1124
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