Individual
MS. ADRIANA TAYDE HERMOSILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7090 MIRATECH DR, SAN DIEGO, CA 92121-3109
(858) 304-6440
Mailing address
3554 BEYER BLVD APT 206, SAN YSIDRO, CA 92173-1316
(619) 240-1262
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB709599
CA
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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