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General NPI Number Information
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NPI Number | 1457271868
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Entity Type | Individual
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Provider Name | MARICELA PONCE
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Gender |
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Dates
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Enumeration Date | 07/16/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 351 S HUDSON AVE # 130
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City | PASADENA
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State | CA
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Zip | 91101-3507
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Country | US
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Telephone | 831-221-6093
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Fax |
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Provider Business Mailing Address
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Address Line | 11125 BASYE ST APT A
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City | EL MONTE
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State | CA
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Zip | 91731-1672
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Country | US
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Telephone | 626-417-0367
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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 |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | CA
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