Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1093392128 |
---|---|
Provider Name | Joseph Gutierrez |
First Address | Los Angeles, CA 90010-3537 |
Second Address | Anaheim, CA 92805-3877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2021 |
Last Update Date | 25/03/2021 |