Individual
GENESIS PUENTE-RANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4540 HARLIN DR, SACRAMENTO, CA 95826-9716
(916) 364-7800
Mailing address
4540 HARLIN DR, SACRAMENTO, CA 95826-9716
(916) 364-7800
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
18-54559
CA
225400000X
Rehabilitation Practitioner
Primary
18-54559
CA
Other
Enumeration date
06/05/2018
Last updated
04/01/2019
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