Most Relevant Information
Provider Data
| NPI Number: | 1003675794 |
| Provider Name: | ANDREA BRISENO RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-21-152279 |
Most Important Dates
| Enumeration Date: | 03/15/2024 |
| Last Updated: | 08/28/2024 |
Provider Practice Location
1212 W AVENUE J
LANCASTER
CA
935342940
Practice Location Phone/Fax
| Phone: | 6612205508 |
| Fax: | 8189917722 |
Provider Mailing Location
16600 SHERMAN WAY STE 175
VAN NUYS
CA
914063847
Provider Mailing Phone/Fax
| Phone: | 8189917722 |
| Fax: | 8189917722 |