Provider Demographics
NPI:1992538805
Name:MUNOZ, MICHELLE ALESSANDRA
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ALESSANDRA
Last Name:MUNOZ
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 1:241 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-1310
Mailing Address - Country:US
Mailing Address - Phone:510-936-4653
Mailing Address - Fax:
Practice Address - Street 1:241 TAMARACK DR
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1310
Practice Address - Country:US
Practice Address - Phone:510-936-4653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst