Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician |
NPI | 1003491846 |
---|---|
Provider Name | Angel Emilio Gonzalez |
First Address | Sun Valley, CA 91352-4439 |
Second Address | Sun Valley, CA 91352-4439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2021 |
Last Update Date | 12/03/2021 |