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NPI 1386267599

NPI 1386267599 : NAOMI POTTS : RIVERSIDE, CA

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General NPI Number Information
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    NPI Number           |    1386267599
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    Entity Type          |    Individual 
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    Provider Name        |    NAOMI POTTS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/21/2020
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    Last Update Date     |    05/21/2020
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Provider Practice Location Address
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    Address Line         |    4193 FLAT ROCK DR STE 220 
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    City                 |    RIVERSIDE
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    State                |    CA
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    Zip                  |    92505-7113
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    Country              |    US
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    Telephone            |    760-453-9157
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10570 MOUNTAIN VIEW AVE APT I 
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    City                 |    REDLANDS
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    State                |    CA
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    Zip                  |    92373-8410
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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        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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