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1063068336
DESIRE SALLY DERRERA
MORENO VALLEY, CA
NPI
1063068336
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA F3612422)
Enumeration Date
2019-08-13
Last Update Date
2019-08-13
Business Address
MS. DESIRE SALLY DERRERA BS
12125 DAY ST STE 301
MORENO VALLEY, CA 92557-6702
Phone number: 951-344-2166
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Mailing Address
MS. DESIRE SALLY DERRERA BS
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number: 818-345-2345
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