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General NPI Number Information
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NPI Number | 1689176679
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Entity Type | Individual
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Provider Name | ALISON MARIE SMITH CRUZ BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 5170 GOLDEN FOOTHILL PKWY
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9608
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Country | US
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Telephone | 916-524-7493
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 NEPTUNE WAY
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City | SACRAMENTO
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State | CA
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Zip | 95864-0859
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Country | US
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Telephone |
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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 | 1-20-43107
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License Number State | CA
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