Provider Demographics
NPI:1710688163
Name:BOCALA, BRIANA ALIZE
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:ALIZE
Last Name:BOCALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20843 HILLSDALE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-2529
Mailing Address - Country:US
Mailing Address - Phone:951-907-4996
Mailing Address - Fax:
Practice Address - Street 1:20843 HILLSDALE RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-2529
Practice Address - Country:US
Practice Address - Phone:951-907-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician