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NPI Code Detail

MEDICARE: ELENA BRICENO

MEDICARE: ELENA BRICENO
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 Analyst
2103K00000XBehavior AnalystCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
188-2277785OTHERCAABA THERAPY

General Provider Information

NPI Number : 1295255164
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELENA BRICENO
Provider Business Mailing Address
First Line : 892 JAMES PL
Second Line :
City : POMONA
State : CA
Zip : 91767-3310
Country : US
Telephone Number : 626-313-8421
Fax Number :
Provider Business Practice Location Address
First Line : 77711 FLORA RD STE 327
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-4103
Country : US
Telephone Number : 626-313-8421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2017
Last Update Date : 05/23/2022

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Directions to “ ELENA BRICENO ” Practice Location

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