MEDICARE: CLAUDIA RIQUELME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1023436797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA RIQUELME

Provider Business Mailing Address
First Line	:	26265 YOLANDA ST
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92656-3112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26265 YOLANDA ST
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92656-3112
Country	:	US
Telephone Number	:	949-290-3077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	03/31/2014

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Directions to “ CLAUDIA RIQUELME ” Practice Location

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