Most Relevant Information
Provider Data
| NPI Number: | 1003461542 |
| Provider Name: | KATHLEEN RYAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/01/2019 |
| Last Updated: | 08/01/2019 |
Provider Practice Location
751 CAMINO PLZ
SUITE A
SAN BRUNO
CA
940663401
Practice Location Phone/Fax
| Phone: | 3039898169 |
| Fax: |
Provider Mailing Location
751 CAMINO PLZ
SUITE A
SAN BRUNO
CA
940663401
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |