Missac Gonzalez
Behavior Technician in Costa Mesa, CA. Individual provider (NPI-1).
NPI number1861962011
StatusActive
Last updated in NPPESNov 30, 2018
Details
- NPI
- 1861962011
- Entity type
- Individual (NPI-1)
- Name
- Missac Gonzalez
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 30, 2018
- Last updated
- Nov 30, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1111 Baker StCosta Mesa, CA 92626-4138
Phone 818-241-6780 · Fax 818-241-6853
Mailing address
206 N Jackson St Ste 202Glendale, CA 91206-4330
Phone 818-241-6780 · Fax 818-241-6853
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