Individual
ANGELYNE LANDICHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9355 E STOCKTON BLVD STE 100, ELK GROVE, CA 95624-9476
(916) 683-1109
(916) 683-1140
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
(209) 572-2589
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42895
CA
106E00000X
Assistant Behavior Analyst
0-17-7918
CA
Other
Enumeration date
07/10/2017
Last updated
07/27/2021
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