Crystal Medrano Avila, BI
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1982118238
StatusActive
Last updated in NPPESNov 23, 2017
Details
- NPI
- 1982118238
- Entity type
- Individual (NPI-1)
- Name
- Miss Crystal Medrano Avila
- Credential
- BI
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 23, 2017
- Last updated
- Nov 23, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-17-42571 | CA | Yes |
Other names
- Crystal Avila Medrano (Other Name)
Practice location
15373 Innovation Dr Ste 200San Diego, CA 92128-3425
Phone 858-699-7579 · Fax 858-726-6021
Mailing address
15373 Innovation Dr Ste 200San Diego, CA 92128-3425
Phone 858-699-7579 · Fax 858-726-6021
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