Organization
AZUL CENTER FOR INTEGRATION
Active
Other names
Azul Center for Integration
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA CARMEN COVARRUBIAS BCBA (CEO/CLINICAL DIRECTOR)
(559) 313-5177
Entity
Organization
Contact information
Practice address
186 ISLE ROYAL CIRCLE, VACAVILLE, CA 95687
(707) 430-1376
Mailing address
2010A HARBISON DR # 233, VACAVILLE, CA 95687-3900
(559) 313-5177
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-15-19396
BCBA CERTIFICATION
—
01
—
1528425584
NPI REGISTRY
—
Enumeration date
09/16/2020
Last updated
09/16/2020
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