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General NPI Number Information
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NPI Number | 1588120117
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Entity Type | Individual
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Provider Name | BIANCA ALONZO
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 4050 TRUXEL RD STE A
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City | SACRAMENTO
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State | CA
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Zip | 95834-3768
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Country | US
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Telephone | 916-374-0800
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Fax | 916-374-0808
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Provider Business Mailing Address
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Address Line | 7735 STOCKTON BLVD APT 1423
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City | SACRAMENTO
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State | CA
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Zip | 95823-4332
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Country | US
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Telephone | 916-671-2300
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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 | Y3907284
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License Number State | CA
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