NPI 1114543162

Nely Pena

Practitioner Assistant Behavior Analyst Granite Bay, CA

Practice location

Address: 4196 Douglas Blvd STE 100, Granite Bay, CA 95746-5904
Phone: (916) 489-1376
Fax: (916) 489-1386
Mailing address: PO Box 5157, Modesto, CA 95352-5157

Registered specialties

Assistant Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 106E00000X

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Registry record

NPI: 1114543162
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Jun 2020
Record last updated: 24 Jun 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.