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NPI 1871240432

NPI 1871240432 : MS. CASHAY C FAVORS : PASADENA, CA

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General NPI Number Information
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    NPI Number           |    1871240432
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    Entity Type          |    Individual 
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    Provider Name        |    MS. CASHAY C FAVORS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/03/2022
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    Last Update Date     |    03/03/2022
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Provider Practice Location Address
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    Address Line         |    DEPT LA 22763 
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    City                 |    PASADENA
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    State                |    CA
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    Zip                  |    91185-0001
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    Country              |    US
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    Telephone            |    866-523-4268
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    265 CLIPPER CT 
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    City                 |    ATWATER
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    State                |    CA
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    Zip                  |    95301-4766
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    Country              |    US
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    Telephone            |    209-587-9356
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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       |    
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    License Number State |    
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