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General NPI Number Information
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NPI Number | 1235944216
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Entity Type | Individual
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Provider Name | SERENITY GOPAR
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Gender | Female
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Dates
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Enumeration Date | 02/08/2025
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Last Update Date | 02/08/2025
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Provider Practice Location Address
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Address Line | 690 MANCHESTER DR
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City | LOS BANOS
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State | CA
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Zip | 93635-5447
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Country | US
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Telephone | 209-829-5406
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Fax |
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Provider Business Mailing Address
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Address Line | 690 MANCHESTER DR
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City | LOS BANOS
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State | CA
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Zip | 93635-5447
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Country | US
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Telephone |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | Y9868644
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License Number State | CA
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