Individual
MR. ATANACIO RYAN GONZALEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 E RINCON ST, CORONA, CA 92879-1367
(714) 415-9509
Mailing address
255 E RINCON ST, CORONA, CA 92879-1367
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27007
CA
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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