Prinston Abel Fontenberry, Associates
Behavior Technician in Lathrop, CA. Individual provider (NPI-1).
NPI number1215744107
StatusActive
Last updated in NPPESDec 26, 2024
Details
- NPI
- 1215744107
- Entity type
- Individual (NPI-1)
- Name
- Prinston Abel Fontenberry
- Credential
- Associates
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 13, 2024
- Certification date
- Dec 26, 2024
- Last updated
- Dec 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
13382 Pipestone StLathrop, CA 95330-8825
Phone 209-752-0079
Mailing address
13382 Pipestone StLathrop, CA 95330-8825
Phone 209-752-0079
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