Most Relevant Information
Provider Data
  | NPI Number: | 1003546011 | 
| Provider Name: | SERENA BURGOS | 
| Entity Type: | Individual | 
| Taxonomy Code: | 106S00000X | 
| Specialty: | Behavior Technician | 
| License Number: | 
Most Important Dates
  | Enumeration Date: | 06/13/2022 | 
| Last Updated: | 06/13/2022 | 
Provider Practice Location
  501 W BROADWAY STE 800
      
      SAN DIEGO
      CA
      921013546
  Practice Location Phone/Fax
      | Phone: | 8774182978 | 
| Fax: | 
Provider Mailing Location
  350 FAIRWAY DR STE 101
      
      DEERFIELD BEACH
      FL
      334411834
  Provider Mailing Phone/Fax
      | Phone: | 8774182978 | 
| Fax: | 8665002186 |