Provider Demographics
NPI:1528783446
Name:SERUJO, CECILIA ZAMORA (RBT)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:ZAMORA
Last Name:SERUJO
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 1:2780 ENTERPRISE RD UNIT 4101
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-1743
Mailing Address - Country:US
Mailing Address - Phone:925-237-0180
Mailing Address - Fax:
Practice Address - Street 1:9400 GATEWAY DR STE A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8907
Practice Address - Country:US
Practice Address - Phone:775-348-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician