Individual
ALEJANDRA VILLASENSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 14TH ST, MODESTO, CA 95354-1003
(209) 572-2589
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
(209) 572-2589
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1847651
CA
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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