Individual
JASON STEVE HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
578 WASHINGTON BLVD, MARINA DEL REY, CA 90292-5421
(424) 272-5238
Mailing address
578 WASHINGTON BLVD, MARINA DEL REY, CA 90292-5421
(424) 272-5238
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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