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General NPI Number Information
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NPI Number | 1629529128
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Entity Type | Individual
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Provider Name | ALLIZA ANNE CABRERA KANGLEON M.S., BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 161 BUTCHER RD STE B
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City | VACAVILLE
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State | CA
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Zip | 95687-5685
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Country | US
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Telephone | 707-305-1118
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Fax |
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Provider Business Mailing Address
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Address Line | 875 HELMSLEY DRIVE
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City | VACAVILLE
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State | CA
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Zip | 95687-8260
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Country | US
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Telephone | 707-342-3331
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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 | 1-17-25585
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License Number State | CA
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