Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-17-25788 | CA |
NPI | 1003349507 |
---|---|
Provider Name | Paolo Jacinto |
First Address | Woodland Hills, CA 91367-4976 |
Second Address | North Hollywood, CA 91607-4921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2017 |
Last Update Date | 11/04/2017 |