Healthcare Provider Details

I. General information

NPI: 1780353276
Provider Name (Legal Business Name): FRANKY MARIE VERRA VASQUES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARNOLD RD STE 102B
DUBLIN CA
94568-7726
US

IV. Provider business mailing address

2730 SHADELANDS DR BLDG 10
WALNUT CREEK CA
94598-2538
US

V. Phone/Fax

Practice location:
  • Phone: 650-376-4230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: