Individual
SUMMER HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4196 DOUGLAS BLVD, GRANITE BAY, CA 95746-5904
(916) 489-1376
(916) 489-1386
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
(209) 572-2589
(209) 572-1461
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
1-10-7233
CA
106S00000X
Behavior Technician
16-24183
CA
Other
Enumeration date
05/23/2018
Last updated
01/03/2022
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