Individual
AUTUMN VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12604 HIDDENCREEK WAY STE C, CERRITOS, CA 90703-2137
(562) 760-4429
Mailing address
16782 VON KARMAN AVE STE 11, IRVINE, CA 92606-2417
(855) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38642
CA
106S00000X
Behavior Technician
RBT-18-47498
CA
Other
Enumeration date
07/26/2018
Last updated
11/13/2020
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