Carlos Mata, B.S.
Behavior Technician in Ontario, CA. Individual provider (NPI-1).
NPI number1023554367
StatusActive
Last updated in NPPESJan 10, 2017
Details
- NPI
- 1023554367
- Entity type
- Individual (NPI-1)
- Name
- Carlos Mata
- Credential
- B.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 10, 2017
- Last updated
- Jan 10, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
3602 Inland Empire BlvdOntario, CA 91764-4900
Phone 909-476-6464
Mailing address
3602 Inland Empire BlvdOntario, CA 91764-4900
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