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NPI Code Detail

MEDICARE: DANIELA SAN ELIAS CERVANTES

MEDICARE: DANIELA SAN ELIAS CERVANTES
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1285265009
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA SAN ELIAS CERVANTES
Provider Business Mailing Address
First Line : 336 E SANTA FE AVE UNIT 111
Second Line :
City : FULLERTON
State : CA
Zip : 92832-4021
Country : US
Telephone Number : 714-581-2971
Fax Number :
Provider Business Practice Location Address
First Line : 701 W KIMBERLY AVE STE 125
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-6346
Country : US
Telephone Number : 714-203-6595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2020
Last Update Date : 01/30/2020

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Directions to “ DANIELA SAN ELIAS CERVANTES ” Practice Location

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