Individual
AMBER VISITACION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 ROYALTY DR, POMONA, CA 91767-3032
(855) 223-7123
Mailing address
1900 ROYALTY DR, POMONA, CA 91767-3032
(855) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
175T00000X
Peer Specialist
Primary
MPSS-WAEYKL
CA
Other
Enumeration date
10/07/2024
Last updated
07/27/2026
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