Individual
ANA CARMEN JERONIMO SOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 TYLER AVE, EL MONTE, CA 91733-3543
(562) 332-3641
Mailing address
2000 TYLER AVE, EL MONTE, CA 91733-3543
(562) 332-3641
(562) 334-3518
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171M00000X
—
CA
Enumeration date
05/06/2019
Last updated
05/10/2022
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