Individual
CAROLINA A CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1300 ETHAN WAY STE 175, SACRAMENTO, CA 95825-2277
(866) 523-4268
Mailing address
DEPT LA 22763, PASADENA, CA 91185-2763
(866) 523-4268
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-53332
CA
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497292965
BAY ABA
CA
Enumeration date
10/04/2021
Last updated
05/15/2023
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