Individual
MS. BRYANNA NICOLE PONGRAPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
12443 LEWIS ST, GARDEN GROVE, CA 92840-4650
(714) 748-4440
Mailing address
28 MERIDIAN DR, ALISO VIEJO, CA 92656-2696
(949) 350-3811
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-13-5266
CA
Other
Enumeration date
03/04/2013
Last updated
01/27/2015
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