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General NPI Number Information
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NPI Number | 1073423265
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Entity Type | Individual
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Provider Name | ILEANA ABIGAIL RIZO BAUTISTA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 4880 MARKET ST
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City | VENTURA
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State | CA
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Zip | 93003-7783
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Country | US
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Telephone | 408-824-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 195 E SAN FERNANDO ST
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City | SAN JOSE
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State | CA
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Zip | 95112-3503
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Country | US
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Telephone | 888-331-2181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CA
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