Individual
JAY ANTHONY NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLPA
Contact information
Practice address
1000 S FREMONT AVE BLDG A10N, ALHAMBRA, CA 91803-8800
(626) 289-7472
Mailing address
1111 W 6TH ST STE 11, LOS ANGELES, CA 90017-1800
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SPA4365
CA
Other
Enumeration date
07/20/2017
Last updated
03/17/2018
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