Individual
ANTONIO RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3160 CROW CANYON PL. #205, SAN RAMON, UT 84101-8410
(818) 241-6780
Mailing address
206 N JACKSON ST STE 202, GLENDALE, CA 91206-4330
(818) 241-6780
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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