Individual
BRISEIDA GAVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3650 MT DIABLO BLVD STE 107, LAFAYETTE, CA 94549-3780
(510) 665-9700
Mailing address
15327 RUGGLES ST, SAN LEANDRO, CA 94579-2025
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/11/2018
Last updated
01/09/2020
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