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NPI Code Detail

MEDICARE: ALICIA JUAREZ

MEDICARE: ALICIA JUAREZ
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 : 1346872314
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA JUAREZ
Provider Business Mailing Address
First Line : 12134 208TH ST
Second Line :
City : LAKEWOOD
State : CA
Zip : 90715-1510
Country : US
Telephone Number : 562-712-7923
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 : 714-415-8918
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2020
Last Update Date : 02/07/2020

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Directions to “ ALICIA JUAREZ ” Practice Location

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