MEDICARE: SANDRA ALHELI HERRERA

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	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1770356651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ALHELI HERRERA

Provider Business Mailing Address
First Line	:	1785 ORIZABA AVE APT B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-1646
Country	:	US
Telephone Number	:	562-810-2691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1785 ORIZABA AVE APT B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-1646
Country	:	US
Telephone Number	:	562-810-2691
Fax Number	:

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

Provider Enumeration Date	:	11/02/2023
Last Update Date	:	11/02/2023

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Directions to “ SANDRA ALHELI HERRERA ” Practice Location

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