Provider Demographics
NPI:1902423619
Name:FIRME, SELENE
Entity Type:Individual
Prefix:
First Name:SELENE
Middle Name:
Last Name:FIRME
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 1:1431 VISTA DE SOLEDAD
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-3575
Mailing Address - Country:US
Mailing Address - Phone:831-428-1270
Mailing Address - Fax:
Practice Address - Street 1:2199 H DELA ROSA SR ST
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-3381
Practice Address - Country:US
Practice Address - Phone:831-223-4949
Practice Address - Fax:407-574-3091
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician