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General NPI Number Information
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NPI Number | 1871153502
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Entity Type | Individual
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Provider Name | SALLY ANNE UNGHEANU BA, RBT
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 3230 E IMPERIAL HWY STE 203
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City | BREA
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State | CA
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Zip | 92821-1706
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Country | US
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Telephone | 657-444-9002
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 SHERWOOD VILLAGE CIR
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City | PLACENTIA
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State | CA
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Zip | 92870-3119
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Country | US
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Telephone | 714-519-5917
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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 | RBT-17-41591
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License Number State | CA
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