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General NPI Number Information
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NPI Number | 1568939296
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Entity Type | Individual
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Provider Name | ROXANA AMPARO VENTURA
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Gender | Female
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 919 CORAL RIDGE CIR
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City | RODEO
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State | CA
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Zip | 94572-1807
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Country | US
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Telephone | 510-478-8854
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Fax |
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Provider Business Mailing Address
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Address Line | 919 CORAL RIDGE CIR
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City | RODEO
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State | CA
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Zip | 94572-1807
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Country | US
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Telephone | 510-478-8854
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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 | Y8423072
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License Number State | CA
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