Individual
MR. BRYAN DE LA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44423 HANSTEAD AVE, LANCASTER, CA 93535-3224
(310) 791-3064
Mailing address
44423 HANSTEAD AVE, LANCASTER, CA 93535-3224
(310) 791-3064
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
06/10/2025
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