Provider Demographics
NPI:1619684057
Name:ROJAS, KIANA (RBT)
Entity Type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95017-0221
Mailing Address - Country:US
Mailing Address - Phone:831-245-9778
Mailing Address - Fax:
Practice Address - Street 1:500 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:CA
Practice Address - Zip Code:95017-9747
Practice Address - Country:US
Practice Address - Phone:831-245-9778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARBT-19-102972OtherREGISTERED BEHAVIOR TECHNICIAN