Organization
AZUL CENTER FOR INTEGRATION
Active
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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