Individual
ANTHONY DIEGO GAXIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20261 SUGAR GUM RD, RIVERSIDE, CA 92508-3011
(951) 212-7846
Mailing address
20261 SUGAR GUM RD, RIVERSIDE, CA 92508-3011
(951) 212-7846
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
7499
CA
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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