Individual
BERENICE ASCENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 ANTIQUE ROSE WAY, RIVERBANK, CA 95367-9505
(209) 521-4791
(209) 521-4794
Mailing address
3425 COFFEE RD STE C2, MODESTO, CA 95355-1582
(209) 521-4791
(209) 521-4794
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CA
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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