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General NPI Number Information
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NPI Number | 1467339713
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Entity Type | Individual
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Provider Name | VAJANIQUE RICHARDSON DOULA
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 1000 S FREMONT AVE UNIT 20
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City | ALHAMBRA
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State | CA
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Zip | 91803-8840
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Country | US
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Telephone | 626-349-3838
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Fax | 855-838-9042
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Provider Business Mailing Address
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Address Line | 292 E MONTANA ST
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City | PASADENA
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State | CA
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Zip | 91104-1060
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Country | US
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Telephone | 626-223-0325
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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 | CERTIFICATE
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License Number State | CA
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