Nicholas Elia Gourgouris
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1861985772
StatusActive
Last updated in NPPESJun 14, 2018
Details
- NPI
- 1861985772
- Entity type
- Individual (NPI-1)
- Name
- Nicholas Elia Gourgouris
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 14, 2018
- Last updated
- Jun 14, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-18-54421 | CA | Yes |
Practice location
3731 6th Ave Ste 100San Diego, CA 92103-4383
Phone 855-223-7123
Mailing address
16782 Von Karman Ave Ste 11Irvine, CA 92606-2417
Phone 855-223-7123
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