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General NPI Number Information
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NPI Number | 1437651890
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Entity Type | Individual
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Provider Name | CHRISTINA MONIQUE YANEZ RBT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 18051 N RAY RD
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City | LODI
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State | CA
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Zip | 95242-9309
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Country | US
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Telephone | 916-420-3165
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Fax |
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Provider Business Mailing Address
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Address Line | 1631 GLORIA DR
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City | STOCKTON
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State | CA
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Zip | 95205-2694
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Country | US
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Telephone | 209-561-0676
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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 | 106SOOOOOX
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License Number State | CA
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