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Organization
CORTICA
Active
Organization
CORTICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENISANNE DE OCAMPO DOREGIOS6 (REGISTERED BEHAVIOR TECHNICIAN)
(805) 413-3009
Entity
Organization
Contact information
Practice address
2625 TOWNSGATE RD STE 102, WESTLAKE VILLAGE, CA 91361-5726
(805) 413-3009
Mailing address
1401 LOMBARD ST # 26086, OXNARD, CA 93030-2271
(805) 612-4047
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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