| Angel Behavioral Path Llc | |
|
1150 King Road #40, 152 San Jose CA 95122 | |
| (408) 622-9222 | |
| (699) 202-3173 |
| Full Name | Angel Behavioral Path Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1150 King Road #40, 152, San Jose, California |
| Authorized Official Name and Position | Elsa Cristina Rodriguez Pasto (MANAGER) |
| Authorized Official Contact | 3052994249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Behavioral Path Llc 1150 King Road #40, 152 San Jose CA 95122 Ph: (408) 622-9222 | Angel Behavioral Path Llc 1150 King Road #40, 152 San Jose CA 95122 Ph: (408) 622-9222 |
| NPI Number | 1184296154 |
|---|---|
| Provider Enumeration Date | 07/11/2021 |
| Last Update Date | 08/19/2021 |
| Certification Date | 07/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184296154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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