MEDICARE: AUXILIADORA ROMERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1962001313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUXILIADORA ROMERO

Provider Business Mailing Address
First Line	:	9006 COSTELLO AVE
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-1916
Country	:	US
Telephone Number	:	818-510-2287
Fax Number	:

Provider Business Practice Location Address
First Line	:	9006 COSTELLO AVE
Second Line	:
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-1916
Country	:	US
Telephone Number	:	818-510-2287
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2020
Last Update Date	:	10/17/2020

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Directions to “ AUXILIADORA ROMERO ” Practice Location

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