Individual
ADRIANA BALSELLS HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12395 LEWIS ST STE 202, GARDEN GROVE, CA 92840-4694
(714) 867-6384
Mailing address
10164 ASCOT CIR, HUNTINGTON BEACH, CA 92646-4321
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-18-59225
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2254797
CA DRIVERS LICENSE
CA
Enumeration date
02/13/2019
Last updated
02/13/2019
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