Provider Demographics
NPI:1285106534
Name:NOVOA CIPRIANI, OLGA ROCIO (RBT)
Entity type:Individual
Prefix:MISS
First Name:OLGA
Middle Name:ROCIO
Last Name:NOVOA CIPRIANI
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:236 GEORGIA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5962
Mailing Address - Country:US
Mailing Address - Phone:888-544-5553
Mailing Address - Fax:
Practice Address - Street 1:236 GEORGIA ST STE 102
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5962
Practice Address - Country:US
Practice Address - Phone:888-544-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-18-69724106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician