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Individual

MRS. CARMEN JUDITH BUSTAMANTE ELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3702 RUFFIN RD STE 100, SAN DIEGO, CA 92123-1893
(619) 297-4300
Mailing address
3702 RUFFIN RD STE 100, SAN DIEGO, CA 92123-1893
(619) 297-4300

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79306
CA

Other

Enumeration date
10/28/2022
Last updated
02/19/2025
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