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NPI Code Detail

MEDICARE: MISS LUZ ALEJANDRA GUEVARA MS, BCBA

MEDICARE: MISS LUZ ALEJANDRA GUEVARA MS, BCBA
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
1103K00000XBehavior Analyst1-24-72358CA

General Provider Information

NPI Number : 1215781703
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LUZ ALEJANDRA GUEVARA MS, BCBA
Provider Business Mailing Address
First Line : 501 MARIN ST STE 225
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-4301
Country : US
Telephone Number : 805-413-2213
Fax Number :
Provider Business Practice Location Address
First Line : 501 MARIN ST STE 225
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-4301
Country : US
Telephone Number : 805-413-2213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2024
Last Update Date : 04/12/2024

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