Healthcare Provider Details

I. General information

NPI: 1992213854
Provider Name (Legal Business Name): ADRIANNA NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 VIA CTR STE B
VISTA CA
92081-6056
US

IV. Provider business mailing address

707 CIVIC CENTER DR STE 202
VISTA CA
92084-6162
US

V. Phone/Fax

Practice location:
  • Phone: 760-295-0449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: