Individual
NICOLE ANDREA AREVALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2526 BUSH AVE, RICHMOND, CA 94806-4530
(510) 776-2038
Mailing address
2526 BUSH AVE, RICHMOND, CA 94806-4530
(510) 776-2038
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XDJ93390961D
BLUE CROSS
CA
Enumeration date
06/26/2018
Last updated
06/26/2018
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