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1548735905
STEPHANIE NICOLE LAKE
SAN JOSE, CA
NPI
1548735905
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: CA RBT-18-67225)
Enumeration Date
2018-10-11
Last Update Date
2018-10-11
Business Address
STEPHANIE NICOLE LAKE
1887 MONTEREY HWY STE 225
SAN JOSE, CA 95112-6192
Phone number: 855-223-7123
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Mailing Address
STEPHANIE NICOLE LAKE
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 855-223-7123
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