Individual
AIDAN VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21600 OXNARD ST STE 1030, WOODLAND HILLS, CA 91367-5085
(877) 206-1009
Mailing address
21600 OXNARD ST STE 1030, WOODLAND HILLS, CA 91367-5085
(877) 206-1009
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95555652D
—
CA
Enumeration date
10/26/2020
Last updated
10/29/2020
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