Individual
REGINA MANCILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS BCABA
Contact information
Practice address
605 STANDIFORD AVE STE B, MODESTO, CA 95350-1000
(209) 572-2589
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
0-24-15312
CO
Other
Enumeration date
01/26/2018
Last updated
01/13/2025
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