Most Relevant Information
Provider Data
| NPI Number: | 1003416306 |
| Provider Name: | LISET GUTIERREZ BARRAZA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/27/2020 |
| Last Updated: | 10/27/2020 |
Provider Practice Location
901 SNEATH LN STE 105
SAN BRUNO
CA
940662415
Practice Location Phone/Fax
| Phone: | 6505159882 |
| Fax: |
Provider Mailing Location
16782 VON KARMAN AVE STE 11
IRVINE
CA
926062417
Provider Mailing Phone/Fax
| Phone: | 9498332237 |
| Fax: |