Elisa Antonio
Behavior Technician in Costa Mesa, CA. Individual provider (NPI-1).
NPI number1124587696
StatusActive
Last updated in NPPESMar 14, 2019
Details
- NPI
- 1124587696
- Entity type
- Individual (NPI-1)
- Name
- Elisa Antonio
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2019
- Last updated
- Mar 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1503 S Coast Dr Ste 212Costa Mesa, CA 92626-1534
Phone 949-278-6762
Mailing address
728 W 18th St Apt CCosta Mesa, CA 92627-4200
Phone 949-278-6762
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