Jorge Alberto Rodriguez Fajardo
Behavior Technician in Encino, CA. Individual provider (NPI-1).
NPI number1033979166
StatusActive
Last updated in NPPESMar 19, 2024
Details
- NPI
- 1033979166
- Entity type
- Individual (NPI-1)
- Name
- Jorge Alberto Rodriguez Fajardo
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 19, 2024
- Certification date
- Mar 19, 2024
- Last updated
- Mar 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
16500 Ventura Blvd Ste 414Encino, CA 91436-5050
Phone 818-788-1003
Mailing address
16500 Ventura Blvd Ste 414Encino, CA 91436-5050
Phone 818-788-1003
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