Individual
MISS REBECCA MONIQUE VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 MOUNTAINSIDE DR, CORONA, CA 92882-8913
(714) 797-1936
Mailing address
3001 MOUNTAINSIDE DR, CORONA, CA 92882-8913
(714) 797-1936
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XEA911485742
BLUE SHIELD
CA
Enumeration date
09/28/2022
Last updated
09/28/2022
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