Provider Demographics
NPI:1396585006
Name:BORUNDA, BIANCA ELIZABETH
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:ELIZABETH
Last Name:BORUNDA
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 1:9630 AHMANN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-1003
Mailing Address - Country:US
Mailing Address - Phone:562-900-9244
Mailing Address - Fax:
Practice Address - Street 1:9630 AHMANN AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-1003
Practice Address - Country:US
Practice Address - Phone:562-900-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician