Healthcare Provider Details
I. General information
NPI: 1598563967
Provider Name (Legal Business Name): ALANA MAE ALMODOVAR CERBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 S NORFOLK ST STE 205
SAN MATEO CA
94403-1184
US
IV. Provider business mailing address
25200 SANTA CLARA ST APT 214
HAYWARD CA
94544-2103
US
V. Phone/Fax
- Phone: 650-242-0179
- Fax:
- Phone: 925-470-8756
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: